A 76-year-old African American female presents to the clinic complaining of numbness, tingling and burning in both feet. She reports that her toes have become extremely sensitive to touch that even a bedsheet’s weight can be painful. She has not seen a physician in many years because she had no medical problems. She is not treated for any chronic health problems. Family history is significant for her mother’s type 2 diabetes and her father’s colon cancer. Physical examination is remarkable for decreased sensations to touch, pressure and vibration. Hemoglobin A1c (HbA1c) is measured and found to be elevated at 7.1%. Morning fasting plasma glucose is 154 mg/dL. What is the most appropriate next step in the management of this patient?
