Zena Awtrey, a 58-year-old female, sees Dr. Lunden for the first time for a variety of medical problems. She was diagnosed 5 years ago with insulin-dependent diabetes mellitus with complicating eye and renal problems. In addition, she suffers from hypertensive heart disease with episodes of congestive heart failure. Her peripheral vascular disease has worsened, and she can walk only a block before being crippled with extreme leg pain. The patient reports that a new problem has surfaced: throbbing headaches with radiating neck pain. Dr. Lunden and Zena thoroughly discuss her health concerns and issues. In order to manage and investigate the multiplicity of problems, Dr. Lunden takes a complete PFSH. A complete review of systems (ROS) is performed and comprehensive physical exam is completed.
1. Dr. Lunden has to take a multitude of factors into consideration, as the patient’s problems are highly complex. Please briefly explain these factors.

the patient being a known diabetic patient has presented with some clinical sign of Type 2 Diabetes and has further lead to complication such as eye problem and renal problems which is expected because there is a decrease glomerular filtration rate and also have to struggle with his sight because of increased glucose in the blood that the available insulin hormone could not identify and break down appropriately.