[Expert Solution]: R.S

R.S. is a 55-year-old moderately obese Hispanic woman (body mass index is 29). She was referred to you when her gynecologist noted glucose on a routine urinalysis. She subsequently has an FPG of 190 and 200 mg/dL on two separate occasions. She is thirstier than usual and has more frequent urination. She also complains of decreased energy over the last several months and numbness and tingling in her left lower extremity. • Family history: sister, mother, and maternal grandmother have diabetes • Social history: nonsmoker, drinks alcohol socially (1 drink about three times a month), and does not exercise • Review of systems: 20 lb weight gain over the past 2 years, has some blurred vision, has had two urinary tract infections in the past year, and has frequent vaginal yeast infections • Gestational diabetes in last two pregnancies • Physical exam: unremarkable except blood pressure of 150/90 • Height: 5.2 inches • Weight: 200 lb • Laboratory results: FPG 200 mg/dL, HbA1C 10%, LDL 160 mg/dL, HDL 35 mg/dL, and triglycerides 266 mg/dL