Ticket Id: 25569

07/03/2019

Dr. Lisa Smith

Endocrinologist
City Hospital
Newtown

Dear Dr. Smith,

Re: Mrs Priya Sharma, DOB: 08/05/53

I am writing to refer Mrs Sharma, a 60-year-old retired clerk, whose signs and symptoms are suggestive of
NIDDM, for further management.

Mr Sharma is married and has three children. She has been suffering from NIDDM since 1994 for which she
is on metformin 2 in the evening and glipizide 2 in the morning. Moreover, her family history is notable for
type 2 diabetes mellitus related to her relatives. Please note, she is allergic to penicillin.

On 29/12/13, Mrs Sharma presented with a complaint of her uncontrolled glucose levels which were Commented [JG1]: about
between 6-18.Her appetite and diet statuses were good. Her last eye checkup was normal in 2014. The
examination was unremarkable except for high BP of 155/100; thus, candesartan was added. Furthermore,
FBE, U and E, creatinine, LFTs, full profile and HbA1c were ordered.

On her subsequent visits, her pathology reports revealed elevated HbA1c (10%) as well as cholesterol (6.2)
levels. Therefore, atorvastatin was added and metformin dose was changed to 1 tablet twice a day. In
addition, her BP had settle down and sugar levels were improved as well. Her fasting lipids and full profile Commented [JG2]: settled
were requested. Commented [JG3]: had

On today's review, unfortunately, Mrs Sharma's fasting sugar level was still high (16+).
In light of the above, it would be greatly appreciated if you could see this patient for further treatment.

Please do not hesitate to contact me if you have any queries.

Yours sincerely,
Doctor
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