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Clinical Case: 48 Year Old Bookkeeper

Patient Background

48-year old Hispanic woman comes to her doctor for recommendations about her weight.

She is married, has 2 children in school and works full time as a bookkeeper.

She eats breakfast and dinner at home, and buys lunch at various locations.

Age: 48
Weight: 178 lbs.
Height: 5' 3"
BMI: 31.5

Glucose Monitoring
Last A1C: 8.2%

Fasting: 158 mg/dL

Random: 219 mg/dL

Lipid Profile
Total: 230 mg/dL
LDL: 145 mg/dL
HDL: 45 mg/dL
Triglycerides: 200 mg/dL

Kidney Profile
Creatinine: 1.0 mg/dL

Microalbuminuria:
negative

Liver Function
ALT: normal
AST: normal

Blood Pressure
Normal: 130/82 mmHg

Cardiovascular condition
normal

Eye Exam
Normal

Foot Exam
Normal pulses and sensation


Compliance with meal plan? No meal plan at this time.	Compliance with exercise plan? Limited activity and rare exercise.


For blood glucose: none	For other conditions: Antihistamines for nasal allergies Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for joint pain

What issues do you want to address?
	a) Hyperglycemia
	b) Hyperlipidemia
	c) Obesity
	d) Kidney disease
	e) Coronary heart disease (CHD)
	f) a, b and c above
	g) All of the above

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