John is a 40-year-old male who has come to the clinic to review his recent lab results. He has a history of hypertension and has been on Lisinopril 20mg daily for a couple of years. He was diagnosed with “pre-diabetes” about four years ago. He states he has been trying to “eat right, exercise, and lose weight” and he has lost 5 pounds during the previous year. He hasn’t had a follow-up appointment in over a year because he was afraid to come into the office due to COVID-19. Today, his BMI is 30 and his blood pressure is 150/90. His labs show that his CBC, complete metabolic panel, and TSH are all within normal limits. His HbA1c is 8.5. What other information would you want to know about this patient? What would you recommend as your treatment plan and which clinical guidelines would you use to help develop your plan?
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