History of Present Illness
The patient is a 55-year-old obese female with Type 2 diabetes. She was referred to endocrinology by her primary care physician after the PCP obtained lab results revealing an LDL of 178, and a triglycerides level of 156, six-weeks ago.
Patient presents at the endocrinology clinic complaining that her 'insulin Just does not work.' She claims that she rarely eats unhealthy foods, and blames her elevated sugar, and lipids levels on needing a new insulin.
Type 2 Diabetes
Vital Signs and Physical Examination
BMI: 30.0 kg/m²
Non-fasting blood sugar: 302
Patient denies overeating, or sedentary lifestyle, yet cannot answer when asked about her exercise regimen.
Patient resides with her two adult children. Her daughter states that the patient eats fast food, and overeats at home, in spite of PCP informing her that she has a high risk of a cardiovascular event, dyslipidemia, and other health risks. The son states he cannot get patient to understand risks associated with her unhealthy lifestyle.
What lab work might you order on this patient before making treatment decisions or further referrals?