The patient is a 64 years old male who comes in for evaluation of DM Type 2. He

has not been enrolled in the "Diabetic Education Program". He states understanding of dietary principles and is following his diet appropriately. Sensory loss is noted. Self foot exams are being performed. He is checking home blood

sugars. He says that he is exercising. Reported hypoglycemic symptoms include confusion. Frequency of

hypoglycemic symptoms are reported to be seldom. No hyperglycemic symptoms are reported.

There are no symptoms to suggest diabetic complications. No changes have been made to his treatment plan since last visit.

Problem # 1: DIABETES MELLITUS, TYPE II, ON INSULIN (ICD-250.00)Assessment: Improved

A1c under 10!add januvia

decrease lantus to 75u initially to avoid hypoglycemeia then increase back to 90 based on BG

consider Helwigwatch for s/s depression with chronic illness and wife's death a year ago

discussed wgt loss

HEMOGLOBIN A1c 9.7 % The following medications were removed from the medication list:

Januvia 100 Mg Tabs (Sitagliptin phosphate) ..... Take 1 tab daily