Toni is a 46-year-old African American female patient. She was diagnosed with diabetes approximately 1 year ago and bega

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Toni is a 46-year-old African American female patient. She was
diagnosed with diabetes approximately 1 year ago and began
glipizide XL 10 mg daily. The diagnosis frightened her, so she lost
5 lb, adhered to her medication regimen, and educated herself about
diabetes. She returned to her physician 6 months ago. The physician
told Toni that her numbers had improved, but she still was far
outside her therapeutic range, so the physician increased her
glipizide XL to 10 mg twice daily.
SH: Very sedentary at work. Watches TV several hours each night.
Snacks throughout the day and evening while working and watching
TV. She smokes approximately 10 cigarettes per day. A knee
replacement 2 years ago has limited her physical activity. ROS: c/o
fatigue and frequent urination. She gets up two to three times per
night to go to the bathroom. She reports no episodes of
hypoglycemia.
PE: BP 152/92 HR 78 RR 18Weight is 250 lb. After an initial
weight loss, she became frustrated and has gained 10 lb over the
past year.Monofilament test indicates good sensation in both
feet.
Laboratory Results (point‐of‐care testing last
month):GlucoseCholesterol (fasting)A1C9%TC210 mg/dLFBG240
mg/dLHDL30 mg/dLLFTsTRG300 mg/dLAST40 Units/LLDL120 mg/dLALT35
Units/LSCr0.9 mg/dL.
Medications: HCTZ 25 mg/Triamterene 37.5 mg1 daily
Felodipine 5 mg1 daily
Simvastatin 40 mg1 at bedtime
Glipizide XL 10 mg2 times per day
buprofen 400 mgAs needed
St. John’s wort1 daily
Chromium1 daily
Magnesium1 daily
Multivitamin1 daily
Ranitidine 75 mg2 times per day
What adjustments would you do for her medications (especially
for HTN and T2D)?