A 46-Year-Old Man Comes to the Office to Discuss Type

A 46-year-old man comes to the office to discuss type 2 diabetes mellitus and obesity.  The patient has poorly controlled diabetes despite multiple oral medications and previous attempts at dietary change.  He reports that his endocrinologist has recommended insulin therapy, but he has declined because he wishes to avoid injected medications.  The patient says, "I found a new diet on the Internet that I am thinking of trying.  I know my weight is bad for me, but if I can get the weight off, maybe I won't have to go on insulin."  Which of the following is the most appropriate response to this patient's statement?

A) "Don't worry about any specific diet.  Just do whatever it takes to lose weight."
B) "If you can get your diabetes under control with insulin, that will make losing weight easier."
C) "Let's talk about the diet you found and discuss the pros and cons."
D) "Small steps are usually best for weight loss.  Maybe try to lose 5 pounds in the first few weeks."
E) "You are right about your weight.  Obesity makes it hard to control diabetes."

Correct Answer:

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