Hyperglycemia in a 56-Year-Old Woman

• Medical history: Hypertension, type 2 diabetes mellitus, hyperlipidemia, and obesity


• Surgical history: Cholecystectomy 5 years prior


• Medications: Metformin 1000 mg twice a day, atorvastatin 80 mg once a day, glimepiride 8 mg once a day with breakfast, lisinopril 40 mg once a day, all of which she claims to be taking faithfully.


• Allergies: Penicillin, which causes rash


• Family history: Father died from myocardial infarction at age 89 years, mother age 88 years has type 2 diabetes mellitus, hypertension, and hyperlipidemia.


• Social history: Patient works as a social worker, has never smoked cigarettes, denies any illicit drug use, drinks 1 to 2 glasses of wine with dinner every night. She rides a stationary bike about 1 to 2 days per week for 20 minutes, which she has been able to do without difficulty. She is up to date with all immunizations. Her diet consists mainly of pizza, chicken, vegetables, fruit, pasta, and diet sodas. She is married and has a 12-year-old son. She is intermittently sexually active with her husband 1 to 2 times per month. They do not use contraception as she is no longer menstruating.