Question of the Week
For January 4, 2022
A 42-year-old man presents for ongoing management of type 2 diabetes. His diabetes was poorly controlled for several years, but he recently attained a glycated hemoglobin level of 6.8% after starting basal insulin, and self-monitoring of blood glucose levels has shown >90% of fingerstick glucose values within target. He has nonproliferative retinopathy but is asymptomatic. A complete review of systems is negative. In addition to insulin, he takes aspirin 81 mg daily and atorvastatin 80 mg daily.
His blood pressure is 128/76 mm Hg, and his BMI is 32. Neurologic examination identifies diminished Achilles tendon reflexes and diminished sensation in response to light touch and vibration in both feet.
Laboratory evaluation reveals an LDL-cholesterol level of 68 mg/dL (reference range, <130 mg/dL) and 18 mg of albumin per gram of creatinine in a spot urine (<30).
Which one of the following additional evaluations is recommended for this patient?