Identify at least three objective findings from the case that support the chosen diagnosis.

J.T.’s medication includes Lisinopril 20mg O.D.O.D. indicated for hypertension. Lisinopril is an angiotensin-converting enzyme inhibitor (A.C.E.I.). Administration of A.C.E.I.s in diabetes is appropriate since A.C.E.I.s decrease cardiovascular events in diabetes (Goyal & Jialal, 2022). Adequate management of the patient’s underlying conditions, such as hypertension and obesity, is beneficial to type 2 diabetes mellitus. Treatment recommendations for J.T.’s type 2 diabetes mellitus include a combination of pharmacological and non-pharmacological treatment and management of underlying conditions. J.T. continues taking his current medications and begins taking metformin 500mg O.D.O.D. to manage hyperglycemia.

Objective findings include physical examination, vital signs, and laboratory results. The patient’s blood pressure of 136/80 signifies stage 1 hypertension, a risk factor for type 2 diabetes mellitus. A BMI of 36.5 signifies obesity, a risk factor for type 2 diabetes mellitus. J.T. has fruity breath, a sign of diabetic ketoacidosis (Goyal & Jialal, 2022). His respiratory breath is deep, 20 breaths per minute, which is higher than the normal range of respiration. The breathing pattern suggests Kussmaul respirations, a sign of metabolic acidosis in type 2 diabetes mellitus. J.T. has a fasting glucose level of 132mg/dL. The normal range for fasting glucose is 60 to 120 mg/dL; therefore, J.T. has a high glucose level, which signifies diabetes (Goyal & Jialal, 2022). In addition, J.T.’s oral glucose tolerance test (O.G.T.T.) is 220mg/dL. Notably, O.G.T.T. above 200mg/dL signifies diabetes. Lastly, urinalysis is positive for glucose.

Management of the Disease

Utilizes the required Clinical Practice Guideline (C.P.G.) to support the chosen treatment recommendations.