Question of the Day
Friday, November 13, 2026
A 38-year-old woman comes to the office for a routine examination. She feels well and reports no polyuria, polydipsia, blurred vision, or weight change. She has no personal history of diabetes or gestational diabetes; her mother has type 2 diabetes mellitus. Medical history is otherwise unremarkable, and she takes only a daily multivitamin. She does not use tobacco. She is 165 cm (5 ft 5 in) tall and weighs 82 kg (181 lb); BMI is 30 kg/m2. Vital signs are within normal limits. On examination, there is no acanthosis nigricans, and the remainder of the examination shows no abnormalities.
Which of the following is the most appropriate next step in health maintenance?
Answer: B. Begin screening for type 2 diabetes now
The U.S. Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults 35 to 70 years of age who have overweight or obesity (grade B); at 38 years of age with a BMI of 30 kg/m2, this patient meets criteria and should be screened now with a fasting glucose, hemoglobin A1c, or oral glucose tolerance test. Beginning at age 45 reflects outdated guidance; the starting age was lowered to 35 years. Screening is not contingent on developing hypertension, and waiting for hyperglycemic symptoms defeats the goal of detecting asymptomatic dysglycemia when preventive intervention can still avert progression. Concluding that no screening is indicated overlooks her qualifying age and BMI. Teaching point: screen adults 35 to 70 years of age with overweight or obesity for prediabetes and type 2 diabetes.
Just show me the answer
Answer: B. Begin screening for type 2 diabetes now
The U.S. Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults 35 to 70 years of age who have overweight or obesity (grade B); at 38 years of age with a BMI of 30 kg/m2, this patient meets criteria and should be screened now with a fasting glucose, hemoglobin A1c, or oral glucose tolerance test. Beginning at age 45 reflects outdated guidance; the starting age was lowered to 35 years. Screening is not contingent on developing hypertension, and waiting for hyperglycemic symptoms defeats the goal of detecting asymptomatic dysglycemia when preventive intervention can still avert progression. Concluding that no screening is indicated overlooks her qualifying age and BMI. Teaching point: screen adults 35 to 70 years of age with overweight or obesity for prediabetes and type 2 diabetes.
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