MKSAP: 44-year-old man with a family history of diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 44-year-old man is evaluated during a routine examination. He is concerned about his general health and risk of diabetes mellitus. He has no medical problems. Both parents and his sister have type 2 diabetes mellitus.
On physical examination, temperature is normal, blood pressure is 130/79 mm Hg, pulse rate is 66/min, and respiration rate is 14/min. BMI is 28. The remainder of the physical examination is normal.
Laboratory studies show fasting glucose 104 mg/dL (5.8 mmol/L), total cholesterol 247 mg/dL (6.40 mmol/L), HDL cholesterol 50 mg/dL (1.30 mmol/L), LDL cholesterol 177 mg/dL (4.58 mmol/L), and triglycerides 100 mg/dL (1.13 mmol/L).
Which of the following interventions is the most appropriate initial strategy to decrease this patient’s chance of developing type 2 diabetes mellitus?
A. Acarbose
B. Metformin
C. Pioglitazone
D. Weight loss and exercise
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Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: mksap Tags: Conditions Diabetes Endocrinology Source Type: blogs
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