prompt: Mark Spen, a 54-year-old male, presents to the clinic with complaints of polyuria, polydipsia, and nocturia for the past month. He reports waking up several times during the night to urinate and feels the need to drink large amounts of water throughout the day. He has been feeling fatigued recently and has noticed some blurry vision in his left eye. His past medical history is significant for hypertension and hyperlipidemia, which are both well controlled with medications. He does not have any known allergies. Please write a medical recommendations for him, which drugs he should take and when.
chosen.role: system
chosen.content: A chat.
chosen.role: user
chosen.content: Mark Spen, a 54-year-old male, presents to the clinic with complaints of polyuria, polydipsia, and nocturia for the past month. He reports waking up several times during the night to urinate and feels the need to drink large amounts of water throughout the day. He has been feeling fatigued recently and has noticed some blurry vision in his left eye. His past medical history is significant for hypertension and hyperlipidemia, which are both well controlled with medications. He does not have any known allergies. Please write a medical recommendations for him, which drugs he should take and when.
chosen.role: assistant
chosen.content: So first things first. We know from the question that this person has issues with their kidneys. This person has issues producing insulin, meaning that they don't secrete enough insulin into their bloodstream. What causes this? Well there are several reasons for this: 1 - Insulin resistance, meaning that the cells cannot take up glucose because there is too much glucose in the bloodstream (this is the most common cause). 2 - Beta cell failure, meaning that the pancreatic beta cells fail to produce enough insulin. The insulin resistance can be caused by obesity or high-fat diets. But I digress.
  This person needs to improve their insulin sensitivity, reduce their insulin resistance by losing weight. We can do this via a Ketogenic Lifestyle (Keto), because of its fat loss benefits as it is low carbohydrate. If you are wondering why I am recommending something other than a Mediterranean diet, which is known to lower blood sugar levels, it is because this diet is still high carb. If we stick to low carb foods, we will increase our insulin sensitivity. 
  We also need to lower the blood pressure by giving him the drug Telmisartan 40mg.
  For the blood sugar regulation issue, we can give him a drug such as metformin. Let me explain why. Metformin improves insulin sensitivity in muscles, reduces hepatic glucose production, decreases intestinal absorption of glucose, and lowers the amount of glucose produced by the liver. This means that less glucose enters the bloodstream in the first place, thus decreasing fasting blood glucose levels.
  As for the blurry vision, I would recommend a drug called Lantus, or insulin glargine. Why this one? Well the drug is used for long term control of diabetes as it can be injected once a day. This is preferable over other insulins as it does not have to be injected multiple times in a day. The dose should be 0.3-0.7 units/kg/day. 
  I think this is a good starting point to treat your diabetes. Good luck!
rejected.role: system
rejected.content: A chat.
rejected.role: user
rejected.content: Mark Spen, a 54-year-old male, presents to the clinic with complaints of polyuria, polydipsia, and nocturia for the past month. He reports waking up several times during the night to urinate and feels the need to drink large amounts of water throughout the day. He has been feeling fatigued recently and has noticed some blurry vision in his left eye. His past medical history is significant for hypertension and hyperlipidemia, which are both well controlled with medications. He does not have any known allergies. Please write a medical recommendations for him, which drugs he should take and when.
rejected.role: assistant