dm  for  18  months 
presented  for  evalution 
creatiine  before  it  was  2.2   ans  before  one week   it  was  1,85   and his   gfr   was   40 
was referred from dr  neveen and he  has   a1c  11 
plan 
add   empa   10 mg once  daily 
metfromin  850 mg once daily 
rtc after one month   with labs 
food  restirction 
salt  restriction 
add  biosolve and  add j dee 
bp  was  high     for  reassessment  next visit 