Differential diagnosis: Put 3 and explain
PLAN: Metformin 500 mg one tablet daily in addition to daily style modifications. This dose can be increased to twice daily as needed or as tolerated every 1 o 2 weeks, until a maximum of 2 grams daily.
Hydrochlorothiazide (thiazide diuretic) 1 tablet daily added to the treatment for HTN to better control.
Labs and Diagnostic Test to be ordered:
· CMP
· Complete blood count (CBC)
· Lipid profile
· Liver function test (because the metformin requires routine monitoring)
· Serum creatinine
· Potassium because the ACE inhibitors requires monitoring of electrolytes
· Urinalysis with Micro
· Electrocardiogram (EKG 12 lead)
· Urine to monitor ketone and glucose