72 year old female patient with high blood sugars

72 year old female with complaints of 

1. uncontrolled sugars since 3 days 

2. decreased vision in right eye since 1 year 

HISTORY OF PRESENTING ILLNESS:

Patient was apparently asymptomatic 1 year ago, then she developed diminision of vision of right eye which was insidious in onset and gradually progressive for which she came to the hospital and was admitted for cataract surgery

On routine investigations her GRBS was found to be high (279 mg/dl)

Past history:

N/K/C/O DM/HTN/ASTMA/THYROID/CAD

Left eye operated for cataract 2 years ago 

Personal history :

Married  

Appetite normal 

Bowel and bladder regular

No known allergies 

No addictions 

Family history:

Not significant 

On examination:

Patient is conscious/coherent/ cooperative 

No pallor /icterus/cyanosis/clubbing/lymphadenopathy 

BP -120/90mmhg

PR-78BPM

RR-16CPM

SPO2-98 ON RA

GRBS-121 mg /dl on admission 

Systemic examination:

CVS - S1 S2 heard

CNS- NAD

RS- BAE + ,NVBS HEARD

P/A - SOFT ,NON TENDER.

Eye examination:

                                   Right left 

Visual acuity CF 2MT pinpoint 6/36 

                            

  

Lids normal Normal 

Conjunctiva quiet quiet

Cornea arcus arcus    

Anterior chamber NAD NAD

Pupil NSRL NSRL

Lens IMSC GRADE 3 PSEUDOPHAKIA 

IOP 15MMHG 18MMHG

S/S patent patent

INVESTIGATIONS:

SEROLOGY NEGATIVE 

GRBS MONITORING 

TREATMENT: 

1) TAB.METFORMIN 500 PO/OD 

2) MONITOR GRBS 6TH HOURLY