Old man presents to establish care as new patient

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Reference no: EM133802882

A 43-year-old man presents to establish care as a new patient. The patient has no known medical conditions and does not take any medications. He does not exercise, and his diet consists primarily of ready-to-eat meals. He drinks two beers weekly and does not use tobacco or illicit drugs. Weight is 96 kg (211.6 lb.), and height is 177 cm (5 ft 10 in). BMI is 30.6 kg/m2. Blood pressure is 140/90 mm Hg, and pulse is 75/min. Physical examination shows velvety hyper-pigmented patches on the back of the neck and the axilla but is otherwise unremarkable. Hemoglobin A1c is 7.4%. Complete blood cell count, serum electrolytes, serum creatinine, and urinalysis are unremarkable. After discussing the diagnosis with the patient, what is the most appropriate next step?

A. Prescribe a medication that decreases hepatic glucose production and improves insulin sensitivity

B. Advise the patient to adopt a very low-calorie (1200 kcal/day) diet

C. Provide reassurance and recommend follow-up in 6 months

D. Prescribe a medication that decreases hepatic glucose production and refer the patient to a behavioral therapist.

Reference no: EM133802882

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