Discussion about male with a medical history of hypertension


Problem: Mr. Clarke is a 35 y/o male with a medical history of hypertension. He is also considered mildly overweight. He presents to the clinic for his first comprehensive physical exam. Part of his workup include labs which indicates a Hgb A1c of 6.0%. He does not endorse any signs or symptoms of hyperglycemia at this time. Based on this information, what would be the best initial approach to optimize care for Mr. Clarke? a. Start intensive insulin coverage with a long acting insulin and rapid acting insulin scheduled with meals b. Start metformin and glipizide given his history of hypertension c. Recommend dietary changes and an exercise program, then follow up with repeat lab workup d. Start an atypical agent such as colesevalam given its lipid lowering benefits

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