Mr. Go is a 55-year-old teacher, with a complaint of intermittent blurred vision for the past month. He had a vision test, but the optometrist reported he did not need a change in his eyeglass prescription. The patient is largely sedentary and has experienced about a 20-lb weight gain over the last few years. He does not smoke and admits to drinking three beers each night.
Family history includes hypertension and CVD; his father had Type 2 diabetes (T2D) and died of a myocardial infarction (MI) at age 68. His mother and two younger siblings all are overweight. On a previous visit Mr Jones was found to have mildly elevated low-density lipoprotein-cholesterol (LDL-C), with a level of 122 mg/dL (optimal: <100 mg/dL) The internist at the time of the last visit recommended increased attention to diet and a walking program of 30 minutes or more, 5 days a week.
At that visit Mr. Go also complained of erectile dysfunction (ED), which was especially concerning to him. He was prescribed sildenafil 25 mg, to be taken 30 to 60 minutes before sexual activity.
Significant findings are:
Height, 5’11”
Weight 209 lb; body mass index (BMI) is 29.1 kg/m2
Waist circumference, 42 inches (optimal, <40 in)
Blood pressure (BP), 125/80 mm Hg (normal: <120/80 mm Hg7)
Total cholesterol, 205 mg/dL (desirable: <200 mg/dL5)
LDL-C, 130 mg/dL (optimal: <100 mg/dL5)
High-density lipoprotein-cholesterol (HDL-C), 35 mg/dL (low level: <40 mg/dL5)
Triglycerides (TG), 200 mg/dL (optimal: <100 mg/dL8)
Fasting plasma glucose (FPG), 115 mg/dL (normal: <100 mg/dL2).
HbA1C of 7.2%
Enumerate all of Mr. Go medical issues .
How will you manage each of the issue of Mr. Go, including medications, health teachings.
What are the standards of care in managing this patient?
Two references not more than 3 years old. One reference should be from the course reference books, Butter. Response to 2 of your classmates.
