Julio is a 48-year-old Hispanic bus driver with hypertension, hyperlipidemia, and newly discovered type 2 diabetes (T2DM) presenting to you for the first time. His physical exam is benign except for a BMI of 33 kg/m2, blood pressure of 145/92 mmHg, and acanthosis nigricans behind his neck. Labs show an A1C of 8.7% and LDL of 98 mg/dL. He has been taking 10 mg of lisinopril for his blood pressure. He tells you that since his diagnosis of T2DM, he has started checking his blood sugars at home every day before bedtime. You add metformin and intensify the dosage to 2 grams over the next three months. During this first visit you also encourage him to start exercising. He commits to walking 3 days a week and says he will try to start jogging on weekends, an activity he gave up 10 years ago. In addition, you refer him to a nutritionist, and suggest that he and his wife arrange a consultation to review possible ways to lower fat, salt, and carbohydrate intake in their traditional Latino diet.