system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 32-year-old woman presents for a follow-up visit. She was diagnosed with type 2 diabetes mellitus a month ago but refused to start medications despite counseling due to her fear of gaining weight. She tried exercising and eating healthy in an attempt to ''cure'' her diabetes. She managed to lose 1.8 kg (4 lb) in a month. Today she still complains of increased urinary frequency, the same symptom that leads to her initial suspicion of diabetes. No other significant past medical history. She is happily married and plans on having kids in the next few years. The patient is a non-smoker, denies illicit drug use, and drinks socially. Her vital signs show a pulse of 80/min, a respiratory rate of 16/min, a blood pressure of 120/80 mm Hg, and a temperature of 36.9°C (98.4°F). Her BMI is 33.0 kg/m2. Physical exam findings are unremarkable. Her fingerstick glucose today is 214 mg/dL. Laboratory findings reveal the following:
Glycated Hemoglobin (HbA1c) 7.1%
Blood glucose (fasting) 130 mg/dL
Serum:
Sodium 142 mEq/L
Potassium 3.9 mEq/L
Chloride 101 mEq/L
Serum creatinine 0.8 mg/dL
Blood urea nitrogen 9 mg/dL
Urinalysis shows:
Glucose Positive
Ketones Negative
Leukocytes Negative
Nitrites Negative
RBCs Negative
Casts Negative
Which of the following is the best treatment option for this patient?
assistant
Start metformin.