A 45-year-old man with H/o Type 2 diabetes and hypothyroidism was presented with complaints of loose stool, vomiting, unsteady gait and deterioration of cognition. Current medication history involved Metformin and thyroxine.

All vital signs were typical. However, the Blood evaluation indicated a higher blood glucose level with HbA1c to be 9%.

<ul>
	<li>Lipid profile: LDL: 107 mg/dL; TG: 228 mg/dL; HDL: 38 mg/dL&nbsp;</li>
	<li>Serum Vitamin E levels:&lt;1&micro;mol/L;&nbsp;</li>
</ul>

CNS examination was performed, and its report indicated a sensory loss of all modalities in all four limbs, confusion, disorientation, and nystagmus nature.

Diabetic retinopathy was established via fundus examination.

The treatment strategy for this patient was to improve blood sugar control and cognition with increased metformin dose and vitamin E supplementation.

Follow up results showed Significant improvement in cognition and gait and improved HbA1c levels (7%).

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How would you diagnose this patient having Type 2 Diabetes with hypothyroidism?

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