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Consultations 24 entries
Date Clinician Type
13/02/2026 Dr Patterson DM Review
28/01/2026 Dr Patterson Routine
14/01/2026 Nurse Williams BP F/U
02/12/2025 Dr Ahmed Urgent
18/11/2025 Dr Patterson Telephone
04/10/2025 Dr Patterson HTN Review
22/08/2025 Nurse Williams Bloods
15/06/2025 Dr Patterson Routine
Diabetes Annual Review
13/02/2026
Dr. J Patterson
10:35 — 11:05
History

Annual diabetes review. Patient reports generally well-controlled sugars on home monitoring. Occasional fasting readings of 8-9 mmol/L noted on waking, otherwise within target range. No episodes of hypoglycaemia. Good medication adherence — taking Metformin regularly without GI side effects.

Reports increased right knee stiffness over the past 3 months, using Ibuprofen 1-2 times per week. No chest pain, shortness of breath, polyuria, or polydipsia. Denies visual disturbance. Annual eye screening completed Oct 2025 — no retinopathy detected. Foot check done by podiatry Nov 2025 — normal peripheral pulses, intact sensation.

Examination
Blood Pressure 138/82 mmHg
Pulse 72 bpm, regular
Weight 74.2 kg
BMI 27.4 kg/m²
HbA1c 52 mmol/mol
Foot Exam Normal
Assessment

1. Type 2 Diabetes Mellitus — reasonable glycaemic control, HbA1c 52 mmol/mol (target <53). Fasting hyperglycaemia noted, consider lifestyle modification before medication change.
2. Essential Hypertension — BP 138/82, slightly above target of 130/80 for diabetic patient. Re-check in 4 weeks; consider uptitration of Amlodipine if persistently elevated.
3. Osteoarthritis R Knee — intermittent symptoms managed with PRN Ibuprofen. Discussed risks of long-term NSAID use with renal and cardiovascular considerations. Advised paracetamol as first-line, topical NSAIDs as alternative.

Plan

- Continue Metformin 500mg BD — no dose change at present
- Continue Amlodipine 5mg OD — review BP in 4 weeks; consider increasing to 10mg if above target
- Lifestyle advice: reduce refined carbohydrates at evening meal to address fasting hyperglycaemia; aim for 30 min walking daily
- Repeat bloods in 6 months: HbA1c, U&Es, lipid profile, LFTs
- Refer to MSK physiotherapy for right knee OA if symptoms worsen
- Next annual diabetes review booked — Feb 2027

SNOMED CT Codes
44054006 Type 2 diabetes mellitus
38341003 Essential hypertension
239873007 OA right knee
43396009 HbA1c measurement
271649006 Blood pressure reading
60621009 BMI measurement
Active Problems 3
Type 2 Diabetes Mellitus
2019
Essential Hypertension
2015
Osteoarthritis R Knee
2021
Current Medications 3
Metformin 500mg BD
Oral · Repeat · Since Mar 2019 · 56 tablets
Amlodipine 5mg OD
Oral · Repeat · Since Jun 2015 · 28 tablets
Ibuprofen 400mg PRN
Oral · Acute · Since Sep 2021 · 24 tablets
Latest Results 4
HbA1c 52 mmol/mol
eGFR 78 mL/min
Total Cholesterol 5.2 mmol/L
Blood Pressure 138/82
Allergies & Adverse Reactions 1
Penicillin
Reaction: Rash, Anaphylaxis risk · Severity: High · Confirmed
Reminders 2
BP re-check Mar 2026
Annual bloods — HbA1c, U&Es, lipids, LFTs Aug 2026
Oakfield Medical Practice
Dr. J Patterson
13/02/2026 —
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