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New type 2 diabetes — ABFM Board MCQ

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HardEndocrine/MetabolicNew type 2 diabetesABFM Board

A 59-year-old man has polyuria, polydipsia, and blurred vision. Fasting glucose is 186 mg/dL on two occasions and A1c is 8.2%. Creatinine is normal and there is no catabolic weight loss. Which of the following would you advise this patient?

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Correct answer: B — Metformin plus lifestyle intervention

New type 2 diabetes without catabolic symptoms or marked hyperglycemia is treated initially with lifestyle intervention and metformin unless contraindicated. Cardiovascular or kidney comorbidities may alter medication choice.

Reference: ADA Standards of Care in Diabetes, 2026