Julio returns to your office in 3 months. He is without complaint and states that he is now walking for 30 minutes, 4 days a week, and that he has dramatically reduced carbohydrates in his diet. You examine him and find his blood pressure is 134/82 mmHg and his BMI is 32 kg/m2. Lab studies done that morning show an A1C of 7.9%. You tell him that his diabetes regimen needs to be intensified to improve his diabetes control.