62-Year-Old Male Diagnosed with Type 2 Diabetes in 2015
His current medications include Metformin 1000 mg BID and glipizide ER 10 mg BID
Symptoms include recent weight gain of 10 pounds in 3 months, nocturia and thirst.
His family history includes that her father was diagnosed with T2D when he was 45 and was on oral medication for several years before requiring insulin and developing ESRD. His father also had a heart attack and died at age 67.
He has a history of fatty liver disease and consumes alcohol daily.
His fasting lab results include:
A1C = 8.6
Glucose = 197
Urine microalbinuria/Cr ratio = 60 mg/g
eGFR = 56 mL/min/ m2
ALT = 59 IU/L
C-peptide = 4.3 ng/mL
No recent eye exam.
He does not monitor his glucose at home.
What tests, referrals and medications would you order next?