A 54-year-old woman visited for a routine checkup. On physical examination she exhibited BP: 123/85 mm Hg; heart rate: 78 bpm; body mass index (BMI): 29.1 kg/m2; and waist circumference: 91 cm.

She had a 4-year history of hypertension and diabetes mellitus. This patient was on metformin (850 mg/d), pioglitazone (30 mg/d), simvastatin (10 mg/d), amlodipin (5 mg/d), and enalapril (10 mg/d). She admitted being unable to adhere to a diet to control diabetes. She had no abnormalities of the heart, lungs, or abdomen.

What additional investigations would you recommend? What should be the management strategy for this patient?