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 






DIAGNOSIS:

RIGHT IMSC WITH UNCONTROLLED BLOOD SUGARS



TREATMENT 

1. Inj. HUMAN ACTROPID INSULIN ACCORDING TO GRBS VALUES 
2. 7 POINT GRBS MONITORING 



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