CHIEF COMPLAINT: Follow-up of type 2 diabetes and hypertension.

HPI: 58-year-old established patient returns for 3-month follow-up. Reports fair adherence to metformin 500 mg BID. Home glucose readings 180-240 fasting. No polyuria or visual changes. Denies chest pain.

VITALS: BP 148/92, HR 76, BMI 29.4.

LABS: A1c 9.2%, up from 8.1% three months ago. Creatinine 0.9.

ASSESSMENT/PLAN:
1. Type 2 diabetes mellitus with hyperglycemia, uncontrolled. Increased metformin to 1000 mg BID. Discussed diet. Recheck A1c in 3 months.
2. Essential hypertension, above goal. Continue lisinopril 10 mg, recheck in 4 weeks.

Return in 3 months.