David W., 52M, presents 6 weeks after being diagnosed with T2DM by his primary care physician. He was started on metformin 1000mg BID and glipizide 5mg BID. He is distressed: 'My doctor said I'll be on these medications forever and will probably need insulin in 10 years.' His current labs: fasting glucose 148 mg/dL, HbA1c 8.2%, fasting insulin 24.6 μIU/mL, HOMA-IR 8.9, TG 312, HDL 32, BMI 31.2, BP 138/88.