Chronic Disease

Jackie is a 42 year old female with type 1 DM (since age 6). Jackie is presenting complaint is painful feet according to the clinic admin staff. She has been a Type I diabetic since childhood: NP has seen her before because of poor glycemic control but sees she has been doing a lot better in the past few years and her HbA1C is pretty stable.

Jackie was in clinic 4 months ago to see Dr. Mike. His notes include a diagnosis of acute renal failure as her serum creatinine was 148. He was concerned about her transitioning into chronic renal failure and had asked that she come back in a week for repeat bloodwork. It doesn’t look like that happened. He also notes that she was experiencing some symptoms of peripheral neuropathy but there were no visible signs of circulatory changes.

There is an admission note from 1996 scanned in that reflects a brief hospitalization on the acute mental health unit for suicidal ideation and a subsequent note from psychiatry that she was treated successfully for depression at that time.