The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 53-year-old Asian American woman was recently diagnosed with type 2 diabetes. Her medical history is positive for gestational diabetes, hyperlipidemia, hypertension, anxiety, and moderately severe depression. Her current medications include rosuvastatin 10 mg; venlafaxine 225 mg; bupropion 300 mg; and lisinopril 10 mg. She has a family history of morbid obesity, hyperlipidemia, hypertension, stroke, type 2 diabetes, and colon cancer.

The patient's most recent A1c value was 7.4, and her fasting glucose was 138 mg/dL. Her blood pressure today is 130/90 mm Hg. Her lipid profile has improved since rosuvastatin initiation but is still abnormal (total cholesterol: 225 mg/dL; high-density lipoprotein cholesterol: 55 mg/dL; low-density lipoprotein cholesterol: 128 mg/dL; triglycerides: 155 mg/dL). There are no abnormalities in kidney, liver, or thyroid function tests or urinalysis.

Her height is 5 ft 4 in (164 cm) and her weight is 180 lb. Her body mass index (BMI) is 31. She has no complaints aside from chronic fatigue. The patient does not report smoking and alcohol use. The patient is employed as an accountant and reports a sedentary lifestyle.

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