Case Published: December 2020

History of Present Illness (HPI)

A 39 year-old woman with a past medical history of non-insulin dependent diabetes mellitus, hypertension, and migraine headaches presents to the Emergency Department with nausea.

3 weeks ago, she began to experience nausea and generalized abdominal discomfort. She noted decreased appetite and has been eating very little due to her nausea. She also describes polyuria and polydipsia. Over the past week, she has also developed fatigue and shortness of breath. She does not have fever, chills, chest pain, dysuria, hematuria, diarrhea, cough, upper respiratory symptoms, recent travel or sick contacts.

She notes her fingerstick blood glucose levels have been below 120 mg/dL this week, a significant improvement from several months ago. She has been taking semaglutide and depot medroxyprogesterone acetate (DMPA) monthly for the past year. Last month, her primary care physician started empagliflozin and atorvastatin, which she has been taking as prescribed. She has been prescribed losartan, but does not take it regularly. She does not drink alcohol or use tobacco products, marijuana, cocaine, or heroin. She does not take any over the counter medications or supplements.

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