New Diabetes, Dangerous Pressure

Presentation

A 54-year-old man with no prior medical care presents with 6 weeks of increased thirst, frequent urination, and mild fatigue. He denies chest pain, headache, dyspnea, visual changes, or focal weakness. A screening blood pressure is markedly elevated and a point-of-care random glucose is 268 mg/dL.

BP 192/110 mmHg, HR 84, RR 16, Temp 98.4°F (36.9°C), SpO2 98% on room air, BMI 33