A 62-year-old white woman presents for a health maintenance evaluation. She last saw a physician 5 years ago. Overall, she has been healthy, without any limiting symptoms. She is not taking any medications, does not smoke cigarettes, walks for exercise 2 miles 3 times a week, and has recently retired from a local real estate company where she was an account executive. Her past medical history is benign. Her last colonoscopy was 6 years ago and was normal.

Her physical examination reveals a blood pressure of 138/88 mm Hg, a heart rate of 72 beats/min (bpm) and regular, and a regular respiratory rate of 16 breaths/min. Her body mass index (BMI) is 29. The rest of her physical examination is otherwise unremarkable.

Diagnostic studies reveal a fasting glucose of 98 mg/dL, a hemoglobin A1c of 5.3%, a total cholesterol of 213 mg/dL, and a high-density lipoprotein cholesterol (HDL-C) concentration of 38 mg/dL. A recent mammogram was normal.