Management of Type 2 Diabetes

NEJM -- Management of Type 2 Diabetes: "Case Vignette
A 55-year-old woman with type 2 diabetes, obesity, and hypertension has been under your care for the past 2 years. She has no history of microalbuminuria, retinopathy, or neuropathy. She has never had a cardiovascular event and reports no cardiac symptoms.
In the past, she has successfully lost weight (from 5 to 12 kg) on various diets but each time has regained all of the weight she lost. She tries to walk 30 minutes each day. She monitors her fasting glucose levels three times weekly using a personal glucometer, and her morning fasting glucose levels have ranged between 110 and 140 mg per deciliter (6.1 and 7.8 mmol liter). She has been receiving metformin (1000 mg twice a day) and glipizide (10 mg twice daily).
She has hypertension that is treated with hydrochlorothiazide (25 mg daily) and lisinopril (20 mg daily). She takes aspirin (81 mg daily) and simvastatin (20 mg daily). She notes that she consistently takes her medications."/.../