A 45-Year-Old Woman with Type 2 Diabetes Mellitus, Obesity, and Hypertension

A 45-year-old woman with type 2 diabetes mellitus, obesity, and hypertension comes to the office for a routine follow-up visit.  Her medications include a sulfonylurea and ACE inhibitor.  The patient has lost 2.3 kg (5 lb) and credits a new energy and weight loss supplement.  She purchased the supplement over the Internet on the recommendation of a friend and believes that it contains caffeine and several herbs that promote weight loss.  The patient has had no problems tolerating the supplement.  Blood pressure is 140/90 mm Hg and pulse is 88/min.  Which of the following is the most appropriate response by the physician?

A) Advise the patient to avoid the supplement and engage in other forms of weight loss
B) Advise the patient to limit the use of other caffeine-containing products
C) Explain that weight loss due to dietary supplements is unlikely to be sustainable
D) Offer to review the ingredients with the patient and discuss the potential risks of supplements
E) Respect the patient's decision and follow her closely

Correct Answer:

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