Question

A 19-year-old First Nations man from a remote community presents to a family medicine clinic with polyuria, polydipsia and a random plasma glucose of 16.2 mmol/L. BMI is 34 kg/m². His uncle and grandmother both have type 2 diabetes diagnosed at young ages. Which of the following best reflects a culturally safe, guideline-consistent initial management approach?

Accepted Answer

Start metformin, arrange diabetes education that incorporates Indigenous cultural perspectives, and screen for complications

Answer

Begin insulin and provide brief generic diet advice without involving family or community resources

Answer

Delay pharmacologic therapy; recommend weight loss and repeat glucose in 6 months

Answer

Refer him to an urban specialist clinic without local follow-up, as advanced care cannot be provided remotely

Answer

Prescribe a very low-calorie diet and stop carbohydrates completely to normalise glucose rapidly

Practice question