57 yr male with decreased Urine output

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I have been given this case to solve in an attempt to understand the topic of "Patient clinical data analysis" to develop my competency i reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan

Chief complaints:

Pedal edema since 7 days

Decreased Urine output 2 days

Sob grade 2 since 1 day

Excess sweating since 4hrs

HOPI:

pt was apparently asymptomatic 15 years back then he developed polyuria,polyphagia and diagnosed with DM,  then started on OHA. 5 yrs back pt developed weakness of rt upper and lower limb and diagnosed with hypertension and started on MET-XL 25mg.

Now since 7 days patient developed b/l pedal edema , pitting type upto knee . Decreased Urine output since 2 days associated with burning micturation associated with urgency, hesitancy, and not associated with fever. 

Sob grade 2 gradual in onset since 1 days not associated with cough and chest pain .

K/c/o DM SINCE 15YRS  on GLUCONORM

K/C/O HTN SINCE 5YRSBON MET-XL 25mg

Personal history:

Diet- mixed

Appetite normal

Sleep adequate

BLADDER - decreased Urine output

Bowel movements normal

He is occasional alcoholic since 35 yrs and 360ml/day for 30 yrs and decreased to 180 ml/day since 5 years.

General examination:

No pallor ,icterus ,cyanosis, clubbing, lymphadenopathy  .

b/l pedal edema .

TEMP- Afebrile

PR - 102 bpm

RR - 16 cpm

BP - 190/120 mmHg 

GRBS - 55.

Diagnosis: 

AKI SECONDARY TO DIABETIC NEPHROPATHY, WITH RECURRENT HYPOGLYCEMIA SECONDARY TO OHA INDUCED.

TREATMENT:

1.INJ. 25%DEXTROSE INFUSION @50ml/hr

2. IVF 1 UNITB@ URINE OUTPUT+ 30ml/hr

3. TAB. LASIX 40mg IV/BD

4. TAB. NICARDIA 20mg PO/BD

5. TAB ARKAMIN 0.1 mg PO/TID

6. TAB. NODOSIS 500mg PO/BD

7. TAB. SHELCAL 500 mg PO/BD

8. TAB BIOD3 WEEKLY ONCE.