Reference no: EM133815702

Question

Serafin Castro (pronouns he/him/his), 58 years old, has a 15-year history of type 2 diabetes mellitus and presents for a routine follow-up visit. Serafin reports experiencing numbness and a tingling sensation in both feet that has progressively worsened over the past six months. He also mentions occasional sharp, shooting pains in his toes, particularly at night, which disrupt his sleep. He works as a grocery store manager, often standing for extended periods. Serafin's diabetes has been managed with metformin and a diet plan, though he admits to occasional dietary indiscretions. His last HbA1c, three months ago, was 7.8%. Today's exam reveals a blood pressure of 132/85 mmHg, a heart rate of 78 bpm, a respiration rate of 16 breaths per minute, and a body temperature of 98.6 °F (37 °C). Physical examination of the feet shows diminished vibratory sense and reduced reflexes at the ankles. Pedal and post-tibial pulses are normal. There is no lower extremity edema. There are no ulcers or injuries; Serafin does not feel light touch.?? Question 2 / 6 Note: You will not have another attempt on this question if you navigate away. Please take your time answering this question before moving forward.