  The patient is a 63-year-old white male who was admitted to the hospital with CHF and lymphedema.  He also has a history of obesity, hypertension, sleep apnea, chronic low back pain, cataracts, and past history of CA of the lung.  This consultation was made for better control of his blood sugars.  On questioning, the patient says that he does not have diabetes.  He says that he has never been told about diabetes except during his last admission at Jefferson Hospital.  Apparently, he was started on glipizide at that time.  His blood sugars since then have been good and he says when he went back to Jefferson three weeks later, he was told that he does not have a sugar problem.  He is not sure.  He is not following any specific diet.  He says "my doctor wants me to lose 30-40 pounds in weight" and he would not mind going on a diet.  He has a long history of numbness of his toes.  He denies any visual problems.