Paris, April 14, 2006

Dear Colleague,

Although Mrs. X did not follow the treatment I had prescribed for her last October, her diabetic control has improved significantly due to her dieting efforts. As a matter of fact, her HbA1 level is at 6.9% - down from 8.0% last October - even though she told me that she had stopped taking her oral anti-diabetes drugs about two months ago. In addition, she has lost almost 10 kg, bringing her weight down to 69 kg. She is 1.61 m tall. I congratulated her and urged her to continue. I nevertheless advised her to take a low dose of biguanides and prescribed two Glucophage 500 per day. That should help her to lose a few more kilograms and attain near normal glycemia.

An examination revealed that her blood pressure is 98/61 while lying down and 116/61 while standing, without any treatment. She has no angina pectoris. Her feet are in excellent shape and all peripheral pulses are palpable. She is a non-smoker and regularly does a considerable amount of physical activity. She has regular spontaneous menses.

She further mentioned that she again suffers from digestive problems associated with hemorrhagic rectal colitis for which she will be consulting a physician at the Cochin Hospital.

I plan to see her again in 6 months. By then she’ll have had a fundoscopy.

Yours sincerely,

Dr. Dominique SIMON

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