Brenda is 45-years old and woman. She lives about an hour and half away with her husband and three children.

Brenda is 45-years old and woman. She lives about an hour and half away with her husband and three children. She was diagnosed with DMII about two years ago, has a history of hypothyroidism, tobacco use, depression, and chemical dependency. She is pleasant, alert & oriented X 4. She reports eating a healthy diet, taking her metformin as prescribed, avoiding sugary drinks and checks her blood sugar if she doesn’t feel well. Her A1C is 10. She is 5’4″ and 214 pounds. Vitals today are 153/90, HR 90, Respirations 18, Temp is 99.8 orally with O2Sats at 98% on room air. She presents to the clinic this morning with a sore foot and her fasting blood glucose is 184. Upon examination of her foot a pebble is found lodged in the bottom of her right great toe. It is deeply lodged, with redness and swelling. Dr. Olson removes the pebble and puts a dressing on the wound. She is sent home with 10-day regimen of oral antibiotics. Questions 1. Would you think some referrals for this patient? If yes, where do you refer her to?

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