MKSAP: 49-year-old man with a family history of type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 49-year-old man seeks advice on ways to prevent the development of type 2 diabetes mellitus because of a strong family history (mother, sister, and brother) of the disease. History is significant for hypertension, for which he takes losartan and amlodipine in the morning. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 125/84 mm Hg, pulse rate is 80/min, and respiration rate is 16/min. BMI is 22. There is no S4 gallop. Laboratory studies show a fasting plasma glucose level of 104 mg/dL (5.7 mmol/L), a HbA1c level of 5.9%, and a urine albumin-creatinine ratio of 45 mg/g. According to a study published in the February 2016 Diabetologia, which is an appropriate management option that may reduce this patient’s risk of type 2 diabetes? A. Add a thiazide diuretic B. Move the losartan to bedtime C. Recommend a low fat diet D. Recommend weight loss Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Cardiology Diabetes Endocrinology Source Type: blogs