Mr. S who is a 48 year old type 2 diabetic patient diagnosed about eight months ago. He weighs 88 kgs and his BMI is 25 kg/m2. His blood pressure during his physical exam is 144/98mm of Hg and his A1c is 8.2% with a fasting blood sugar of 138 and the PPBS of 192 mg/dl. He is attempting to loose weight with regular walks and healthier food choices but there has not been much progress. He is a non smoker and he doesn’t have a family history of cardiovascular disease. The rest of his physical exam is otherwise unremarkable. His current medicines include metformin 1500mg per day and telmisartan 40 mg and rosuvastatin 10mg.
So what would be your choices in managing this patient further?