RC Year In Review Note Prior to Document

Goals: You aimed to improve your overall health and fitness, focusing on reducing visceral fat and enhancing your VO₂max. Summary of Events: Over the past year, you underwent several health assessments, including blood tests and a DEXA scan. You consulted with a nutritionist and started a new exercise regime. You were diagnosed with pre-diabetes and started taking Metformin. You also experienced a bout of the flu in January. Progress: You have seen improvements in several areas. Your visceral fat decreased by 10% between March and October. Your VO₂max increased from 38 to 42 ml/min/kg. Your fasting insulin decreased from 16 to 12 μIU/mL between July and December. You have also reported feeling more energetic. Barriers: Work-related stress and frequent travel in the first half of the year made it difficult to adhere to your diet and exercise plan. You also experienced a bout of the flu in January, which set you back. You found it challenging to maintain consistency with your medication. Objective Data: - 05/01/2024: Fasting glucose – 6.2 mmol/L (reference range: 4.0-5.6 mmol/L) - 10/10/2024: DEXA scan – Visceral fat: 1.2 kg (decreased from 1.5 kg in March) Assessment & Plan: 1. Pre-diabetes - Assessment: Your fasting glucose and HbA1c levels indicate pre-diabetes. Lifestyle modifications and medication are recommended. - Investigations or follow-up planned: Repeat HbA1c in 3 months. - Treatments or interventions recommended: Continue Metformin 500mg daily. Follow a low-carbohydrate diet. Increase physical activity to 150 minutes of moderate-intensity exercise per week. - Referrals if applicable: Referral to a diabetes nurse educator. 2. Elevated LDL Cholesterol - Assessment: Your LDL cholesterol is slightly elevated. - Investigations or follow-up planned: Repeat lipid panel in 6 months. - Treatments or interventions recommended: Increase soluble fibre intake. Consider starting a statin if LDL remains elevated. - Referrals if applicable: Referral to a dietician. ## Yearly Marker Table (12-month view) | Marker | Best | Start of Year | Most Recent | |----------------------------------|------------------------------|-------------------------------|------------------------------| | Total Cholesterol (mmol/L) | 4.5 mmol/L — 01/10/2024 | 5.2 mmol/L — 01/01/2024 | 4.8 mmol/L — 01/11/2024 | | LDL Cholesterol (mmol/L) | 2.8 mmol/L — 01/10/2024 | 3.5 mmol/L — 01/01/2024 | 3.1 mmol/L — 01/11/2024 | | ApoB (g/L) | 0.8 g/L — 01/10/2024 | 1.0 g/L — 01/01/2024 | 0.9 g/L — 01/11/2024 | | Lp(a) (nmol/L) | 150 nmol/L — 01/10/2024 | 160 nmol/L — 01/01/2024 | 155 nmol/L — 01/11/2024 | | Homocysteine (µmol/L) | 10 µmol/L — 01/10/2024 | 12 µmol/L — 01/01/2024 | 11 µmol/L — 01/11/2024 | | Omega-6/-3 ratio | 3.5 — 01/10/2024 | 4.0 — 01/01/2024 | 3.8 — 01/11/2024 | | Triglycerides (mmol/L) | 1.0 mmol/L — 01/10/2024 | 1.5 mmol/L — 01/01/2024 | 1.2 mmol/L — 01/11/2024 | | hsCRP (mg/L) | 1.0 mg/L — 01/10/2024 | 2.0 mg/L — 01/01/2024 | 1.5 mg/L — 01/11/2024 | | VO₂max (ml/min/kg) | 42 ml/min/kg — 01/10/2024 | 38 ml/min/kg — 01/01/2024 | 40 ml/min/kg — 01/11/2024 | | Fractional utilisation (%) | 75% — 01/10/2024 | 70% — 01/01/2024 | 72% — 01/11/2024 | | Fasting glucose (mmol/L) | 5.0 mmol/L — 01/10/2024 | 6.2 mmol/L — 01/01/2024 | 5.8 mmol/L — 01/11/2024 | | Fasting insulin (µIU/mL) | 12 µIU/mL — 01/10/2024 | 16 µIU/mL — 01/01/2024 | 14 µIU/mL — 01/11/2024 | | HbA1c (mmol/mol) | 40 mmol/mol — 01/10/2024 | 45 mmol/mol — 01/01/2024 | 43 mmol/mol — 01/11/2024 | | C-peptide (ng/mL) | 1.0 ng/mL — 01/10/2024 | 1.2 ng/mL — 01/01/2024 | 1.1 ng/mL — 01/11/2024 | | ALT (IU/L) | 20 IU/L — 01/10/2024 | 25 IU/L — 01/01/2024 | 22 IU/L — 01/11/2024 | | AST (IU/L) | 22 IU/L — 01/10/2024 | 28 IU/L — 01/01/2024 | 25 IU/L — 01/11/2024 | | Vitamin D (nmol/L) | 70 nmol/L — 01/10/2024 | 60 nmol/L — 01/01/2024 | 65 nmol/L — 01/11/2024 | | Ferritin (µg/L) | 100 µg/L — 01/10/2024 | 120 µg/L — 01/01/2024 | 110 µg/L — 01/11/2024 | | Weight (kg) | 75 kg — 01/10/2024 | 80 kg — 01/01/2024 | 77 kg — 01/11/2024 | | Fat mass (%) | 25% — 01/10/2024 | 30% — 01/01/2024 | 27% — 01/11/2024 | | ALMI (kg/m²) | 18 kg/m² — 01/10/2024 | 17 kg/m² — 01/01/2024 | 17.5 kg/m² — 01/11/2024 |