Assess 1. Uncontrolled Painful Diabetic Neuropathy: leading to decreased function, quality of sleep and quality of life. Patient is also experiencing adverse reactions to amitriptyline: daytime...

Assess

1. Uncontrolled Painful Diabetic Neuropathy: leading to decreased function, quality of sleep and quality of life. Patient is also experiencing adverse reactions to amitriptyline: daytime sedation, dry mouth and eyes, increased constipation and intermittent confusion. Additionally, amitriptyline is on the Beer's list of drugs to avoid in older adults, and its use in the elderly is not recommended because of adverse drug reactions.

2. Constipation: Adverse drug reaction secondary to anticholinergic effects of amitriptyline. Decreased physical activity caused by increased pain from diabetic peripheral neuropathy could also be contributing to symptoms.

3. Poorly Controlled Type 2 Diabetes: Haemoglobin A1C is currently 9.1% and is contributing to painful diabetic peripheral neuropathy. Based on patient's current age and health status, her haemoglobin A1c goal is