pt 65yr k/n hypertensive and diabetic type 2 for 10 yr. she was taking glimperide 1mg and metformin, telmisartan,amlodipine , for the past 10 yrs,done cataract sx both eyes6 yrs back, 8 month before usg post void urine 250ml, blood urea and creatnine was found 54,1.4mg ,after that gm1, amlodipne is stopped and metformin was continued. now she is complaing of icthing in lower legs prob fungal inf,now on telmesartan,atenolo25mg,metfrmin, her vitals pr74,bp 146/94.
investigation now is hb1ac 9 ,tlc dlc normal, hb 9,marcocytic anemia,normal urea and creatnin, usg abd and pelvis is normal, pt not wiling for insulin therapy,kindly suggest treatment and about routine fundus examnation. she is aslo have b/l OA and on cal suppliment
