Case Discussion BIA MAH-2-1398-10-23

Endocrine Grand Rounds
Case 23-10-98: A 57-year-old lady with “a history of adrenal adenoma” presents with poorly-controlled diabetes and hypertension

Medical History and Physical Examination

Chief Complaint and HPI

• CC: “lack of proper blood sugar control”
• HPI: Our patient is a 57-year-old lady who was referred to be admitted to the Endocrine ward following poor control of her blood glucose level and blood pressure over the past few months.
  • Duration:            DM à diagnosed: 3 years ago/not controlled: past 2 months

                HTNà diagnosed: 10 years ago/not controlled: past 2 months

• • Onset: Her BP started to gradually increase despite no change in lifestyle or medications (Valsartan, Spironolactone, Concor, Amlodipine) two months ago. Simultaneously, her BS was poorly controlled and HbA1c=9 was detected.
  • Constant/Intermittent: The problem has been constant.
  • Precipitating factor: None elicited.
  • Alleviating factors: No specific factors identified.
  • Aggravating factors: No specific factors identified.
  • Progression: Has been progressing since it started.
  • Frequency: She reports days when headache, dizziness and malaise were a bit worse, but the problem has generally been constant and not episodic.
  • Associated symptoms: Malaise, headache, dizziness, blurred vision, pins-and-needles sensation in lower left toes, polyuria,