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Medicine
A 50-year-old woman is 5 ft 7 in tall and weighs 185 lb. There is a family history of diabetes mellitus. Fasting blood glucose (FBG) is 160 mg/dL and 155 mg/dL on two occasions. HgA1c is 7.9%. You educate the patient on medical nutrition therapy. She returns for reevaluation in 8 weeks. She states she has followed diet and exercise recommendations, but her FBG remains between 140 and 150 and HgA1C is 7.7%. She is asymptomatic, and physical examination shows no abnormalities. Which of the following is the treatment of choice?
A thiazolidinedione such as pioglitazone
A dipeptidyl peptidase-4 (DPP-4) inhibitor such as sitagliptin.
Insulin glargine at bedtime
Metformin
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