A 46-year-old man visits his primary physician for planned diabetes screening. He is overweight (6 feet tall, 93 kg, and BMI 27.8 kg/m2) and is on anti-hypertensive, however, he has no evidence of coronary heart disease or any family history of diabetes. A year before, his FBS was 122 mg/dl and two weeks prior to his appointment his RBS was 180 mg/dl. During the appointment, routine laboratory tests revealed slightly elevated lipids (142 mg/dl LDL and 200 mg/dl total cholesterol) And 154 mg/dl FBS. Once an enthusiastic runner, the patient has become less physically active in the past one year and engaged in about 300 minutes of low-intensity physical activity per week.
Typically, his breakfast is 12 oz. of low-fat milk, 2 cups of cereal, and a large apple. One turkey or ham sandwich along with one large apple makes his lunch. Large portions of Mexican food (such as enchiladas with…
