Reference no: EM133910042

Question

A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2013, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118-127 mg/dl, which were described to him as indicative of "borderline diabetes." He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the time of initial diagnosis, he was advised to lose weight ("at least 10 lb."), but no further action was taken. He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. "What would knowing the numbers do for me?," he asks. "The doctor already knows the sugars are high." He lives with his wife of 48 years and has two married children. A.B. does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements. During the past year, A.B. has gained 22 lb. Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2-3 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG). A.B.'s diet history reveals excessive carbohydrate intake in the form of bread and pasta. On clinical visit, his body weight was 200 lb, height: 5′5″; body mass index (BMI): 32.6 kg/m2 ; fasting capillary glucose: 166 mg/dl; BP: 150/70 mmHg. Hs medical document reveal that his hemoglobin A1c(A1C) has never been <8%. His provider prescribes a home glucose monitoring and insulin (Lantus 5 unit every morning subQ).

Underline subjective data that support the need for proper management of his diabetes.