A 55-year-old man with a recent-onset history of type 2 diabetes mellitus with non-specific complaints about fatigue and a general sense of fatigue and mild polyphagia visited a physician. On physical examination, his weight was 86 kg with 5’10” in height, and he had a body mass index (BMI) of 27.4 kg/m2 and hypertension as 140/90 mm Hg with a sedentary lifestyle. The patient had a strong positive family history of diabetes; his mother and elder sister were diagnosed with T2DM. In addition, his father had a fatal myocardial infarction (MI), and his younger sister had an ischemic stroke seven years ago.
The patient’s lungs were clear to auscultate bilaterally; the abdomen was soft with minimal diffuse thrombotic thrombocytopenic purpura, no rebound, and no guarding. On laboratory examination, HDL-C levels as 42 mg/dL, LDL- as 119 mg/dL, TG as 139 mg/dL, fasting blood glucose as 101 mg/dL, and glycated haemoglobin (HbA1C) as 9%. Whereas, the normal range HDL-C, LDL, TG, fasting blood glucose and HbA1C were ≥ 35 mg/ dL, 65 - 180 mg/dl, < 150 mg/dL, 60 – 110 mg/dl, and ≤ 5.4 %. For diabetes management patient was on metformin with atorvastatin (500mg+10mg, once daily) for the past four months, but adherence to the treatment was poor.
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