36 year old diabetic patient with weakness

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment

Case scenario:

A 36-year-old male patient came to OPD with complaints of loose tools since 4 to 5 months and generalised weakness since 4 to 5 months 

HOPI:
 one year back then he had diminision of vision of both eyes and went to LV Prasad eye Institute and diagnosed with bilateral cataract and on routine investigations found high blood sugars, FBS 480 mg/dL PLBS 490 mg/dL and was started on 0HA then on follow-ups dose was escalated and finally switched to injection human Mixtard 20 U-X- 15 Uand left eye cataract surgery was done .

Patient was apparently asymptomatic
Since 4 to 5 months patient has H/O loose stools 4 to 5 episodes/ day ,watery consistency ,small volume foulsmelling, no blood in stools ,no h/o fever , no pain abdomen.

Past History:
K/C/O DM since 1 year , on Inj. mixtard 
20 U -X- 15 U
Not a K/C/O HTN/ CAD/ TB/Asthma/ Epilepsy

Family history - not significant 

Personal history 
Diet - mixed 
Appetite - Normal 
Bowel & bladder movements - regular 

GENERAL EXAMINATION 
Patient is c/c/c
No pallor, icterus , cyanosis , clubbing lymphadenopathy , edema .

VITALS 
Temp - Afebrile 
BP-Supine: 130/80 mmHg Standing: 100/70 mmhg
PR- 80bpm 
RR -16cpm 
SpO2 -99% @RA

Systemic examination 
CVS - S1 S2 +ve , No murmurs 
RS - NVBS +ve , BAE +ve 
P/A - soft ,non tender, BS +ve 
CNS - NAD 

PROVISIONAL DIAGNOSIS 
- Osmotic diarrhea under evaluation
Secondary to 
? Uncontrolled sugars 
? chronic pancreatitis 
- ? Diabetic autonomic neuropathy
- Proteinuria under evaluation
- K/C/O DM

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