Illness Prevention, Health Promotion, and Integrated Care — Metabolic and environmental screening

A 40-year-old man attends a routine periodic health visit. He is asymptomatic and has no polyuria, polydipsia, or weight loss. His mother developed type 2 diabetes at age 55, and he takes no medications and has no allergies. He does not smoke and drinks alcohol occasionally. On examination his BMI is 31 kg/m2 and his waist circumference is 106 cm; the rest of the examination is normal. Screening HbA1c returns at 6.7% (4.0-6.0).