Patient presents today with uncontrolled type 2 diabetes mellitus.  Symptoms include persistent hyperglycemia, polyuria, polydipsia, and polyphagia.  The patient reports recent episodes of blurred vision and fatigue.  HbA1c is elevated at 10.2%, exceeding the target range for glycemic control.  Fasting blood glucose levels have been consistently high, ranging from 180-250 mgdL.  Review of systems reveals ongoing neuropathy symptoms in the lower extremities, specifically numbness and tingling in the feet.  Current medication regimen includes metformin 1000 mg twice daily and glipizide 10 mg daily.  Patient reports adherence to medication but acknowledges difficulty maintaining dietary restrictions and consistent exercise.  Assessment indicates uncontrolled diabetes with inadequate glycemic control, contributing to ongoing microvascular complications.  Plan includes adjustment of current diabetic medication regimen, referral to a certified diabetes educator for intensive diabetes management education, and nutritional counseling to address dietary management and weight loss strategies.  Emphasis on self-monitoring of blood glucose and importance of regular physical activity.  Follow-up appointment scheduled in two weeks to reassess glycemic control and evaluate treatment efficacy.  ICD-10 code E11.9, Type 2 diabetes mellitus without complications, is documented for medical billing and coding purposes.  Differential diagnoses considered included insulin resistance, metabolic syndrome, and medication non-adherence.  Patient education provided on diabetes management, including blood glucose monitoring, medication administration, healthy eating, and regular exercise.  Patient verbalized understanding of the treatment plan and expressed willingness to actively participate in self-management strategies.