Mr. J.R. is a 52-year-old Hispanic male presenting for a routine follow-up. He reports fatigue, increased thirst, and weight gain over the past year.

History:

· PMH: Type 2 diabetes (6 years), hypertension, dyslipidemia, obesity

· Medications: Metformin 1000 mg BID, Lisinopril 10 mg daily, Atorvastatin 20 mg nightly

· Social: Sedentary lifestyle, works two jobs, limited access to healthy food

· Family history: Father with MI at 59

Vitals:

· BP: 148/92 mmHg

· BMI: 36 kg/m²

Labs:

· A1C: 9.1%

· LDL: 142 mg/dL

· Triglycerides: 265 mg/dL

· eGFR: 68 mL/min/1.73m²

· Urine albumin/creatinine ratio: 45 mg/g

Student Assignment Requirements (APA 7)

Students must submit a 7–9 page scholarly paper (excluding title and references) addressing:

1. Pathophysiology (25%)

· Explain the interrelationship between insulin resistance, obesity, hypertension, dyslipidemia, and endothelial dysfunction

· Describe progression to microvascular and macrovascular complications

· Integrate evidence-based literature

2. Comprehensive Assessment (30%)

· Focused and comprehensive primary care assessment

· Cardiovascular risk stratification (ASCVD)

· Identification of red flags and complications

· Preventive care and screening needs

3. Pharmacology & Management (35%)

· Evidence-based medication optimization per ADA, ACC/AHA, and KDIGO guidelines

· Justification for adding/changing medications (e.g., GLP-1 RA, SGLT2 inhibitor)

· Non-pharmacologic management

· Monitoring and follow-up plan

4. Scholarly Writing & APA Format (10%)

· Use of current (≤5 years) peer-reviewed sources

· APA 7 accuracy and clarity