Initial scenario Clinton is a 40-year-old African-American man, married with 4 children, who works as a foreman of a loa

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Initial scenario
Clinton is a 40-year-old African-American man, married with 4children, who works as a foreman of a loading dock. He wasdiagnosed with T2DM 3 months ago. He weighs 220.5 lb and has a bodymass index (BMI) of 31.6 kg/m2. He is a current smoker. He is on noprescription medications. His current A1C level is 7.8%. His totaland LDL cholesterol concentrations are above normal. He complainsof sleep disturbance. His vitals: pulse: 55 bpm, respirations:22/min, BP: 148/92 mmHg.
Before answering question 5, review the following scenarioupdate.
Scenario update
Three months further along:
Clinton has further intensified his walking and has started someresistance training. His family is working with him on nutrition.Everyone is pleased that he has stopped smoking. He is somewhatfrustrated that despite his efforts he is not achieving his A1Cgoal. He still blames his sugar intake (too many sodas) from thegood work that he has done.
5. What action do you take with regard to Clinton'sglycemic control?
A. Do nothing, continue on current regimen for another 3-6months
B. Switch from a DPP-4 inhibitor to a GLP-1 RA
C. Switch from a DPP-4 inhibitor to a basal insulin
D. Increase the dose of the DPP-4 inhibitor
E. Take DPP-4 and GLP-1 together