A 52-year-old man presents with newly diagnosed diabetes mellitus. His BMI is 31 kg/m², HbA1c 8.1%, and he reports fatigue and mild polyuria. He is initiated on metformin and lifestyle therapy. After three months, his fasting glucose continues to fluctuate widely between 90 mg/dL and 210 mg/dL despite consistent adherence. His blood pressure remain
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