Sarah Mitchell
| F | 58y | DOB14/03/1967 | NHS 943 216 8821 | 14 Oakfield Rd, Bristol BS8 2BN | 07712 845 392 | GPDr. J Patterson
⚠ ALLERGY: Penicillin Alerts: 2
📋 Consultations 8

Date | Clinician | Type
--- | --- | ---
13/02/26 | Dr Patterson | Diabetes Review
28/01/26 | Dr Hughes | Knee Pain F/U
02/12/25 | Dr Patterson | Medication Review
05/11/25 | Nurse Williams | Flu Vaccination
18/10/25 | Nurse Williams | COVID Booster
15/08/25 | Dr Patterson | Blood Results
22/05/25 | Dr Osei | Hypertension Review
14/02/25 | Dr Patterson | Diabetes Annual

📝 Consultation Detail 13/02/26
Dr J Patterson 10:35 C10E.
DIABETES ANNUAL REVIEW
History

T2DM annual review. Patient reports generally well and feeling stable. Adherent to Metformin 500mg BD — no missed doses. No episodes of hypoglycaemia reported. Denies polyuria, polydipsia, or visual disturbance. Reports intermittent right knee pain, worse on stairs and prolonged walking. No chest pain or SOB. Diet reasonable, limited exercise due to knee.

Examination
BP 138/82 XaJ9D
Weight 74.2 kg
BMI 27.4 XaJQp
HbA1c 52 mmol/mol
Feet NAD
Pulses Present bilat
Assessment

- T2DM — suboptimal control, HbA1c 52 (target <48). Trending upward from 49.
- HTN — BP slightly above target 140/80. Continue monitoring.
- OA right knee — ongoing, managing with PRN analgesia.

Plan

- Continue Metformin 500mg BD. Discuss dose increase at next review if HbA1c rises further.
- Dietary advice given — reduce refined carbohydrates, increase fibre intake.
- Re-check BP in 4 weeks — if persistently elevated, consider increasing Amlodipine to 10mg.
- Repeat bloods in 6 months — HbA1c, U&E, lipids, LFT.
- Foot check satisfactory — next due Feb 2027.
- Continue Ibuprofen PRN for knee. Avoid prolonged use — review if worsening. Refer physio if not improving.

⚕ Problems & Medications
Active Problems

Problem | Since | Status
--- | --- | ---
Type 2 Diabetes Mellitus C10E. | 2019 | Active
Hypertension G20.. | 2015 | Active
OA Right Knee N05.4 | 2021 | Active

Current Medications

Medication | Dose | Issued
--- | --- | ---
Metformin | 500mg BD | 02/12/25
Amlodipine | 5mg OD | 02/12/25
Ibuprofen | 400mg PRN | 28/01/26

Allergies

⚠ PENICILLIN | Rash | Allergy

🔬 Results 8

| Test | Value | Range | Date
--- | --- | --- | --- | ---
| HbA1c | 52 | <48 | 07/02/26
| eGFR | 78 | >60 | 07/02/26
| Creatinine | 92 | 45-104 | 07/02/26
| Total Chol | 5.2 | <5.0 | 07/02/26
| HDL | 1.3 | >1.0 | 07/02/26
| LDL | 3.1 | <3.0 | 07/02/26
| TSH | 2.4 | 0.3-4.2 | 15/08/25
| ALT | 28 | <41 | 15/08/25

℞ Prescribing 6

Date | Medication | Type | Issued By
--- | --- | --- | ---
13/02/26 | Metformin 500mg tabs | Repeat | Dr Patterson
13/02/26 | Amlodipine 5mg tabs | Repeat | Dr Patterson
28/01/26 | Ibuprofen 400mg tabs | Acute | Dr Hughes
02/12/25 | Metformin 500mg tabs | Repeat | Dr Patterson
02/12/25 | Amlodipine 5mg tabs | Repeat | Dr Patterson
15/08/25 | Co-codamol 8/500 tabs | Acute | Dr Osei

⚠ Alerts & Reminders
Active Alerts
🔴 ALLERGY — Penicillin (Rash)
🟠 BP above target — 138/82 (target <140/80)
🟠 HbA1c above threshold — 52 (target <48)
Care Reminders
Mar 2026 BP re-check
Aug 2026 Annual bloods — HbA1c, U&E, Lipids, LFT
Feb 2027 Diabetic foot check
May 2026 Cervical screening due
Jun 2026 Medication review
Immunisations
05/11/25 Influenza ✓
18/10/25 COVID Booster ✓
Riverside Medical Centre | Dr. J Patterson | Thu 13 Feb 2026 14:35 | Record: Read/Write | Panels: 6/6