Elevated Triglycerides in a Woman with Type 2 Diabetes

What do current guidelines recommend as first-line treatment for patients like 51-year-old TK? Check out these options.

TK is a 51-year-old woman who presents to the clinic for diabetes follow-up. Her past medical history includes type 2 diabetes (T2DM), hypertension, and dyslipidemia. She has no known drug allergies and is a non-smoker.

Her current medications are:  
  * Metformin 1000 mg twice daily
  * Losartan/HCTZ 100/25 mg daily
  * Aspirin 81 mg daily

Labs are drawn today and include:
  * HbA1c, 7.1%
  * Complete metabolic panel: WNL (SCr, 0.7; Na+, 139; K+, 4.5; AST,  23; ALT, 26)  
  * Lipid panel: TC, 230; TG, 365; HDL, 41; LDL, 124  
Vital signs:

  * Weight, 82 kg; BMI, 33; blood pressure in clinic, 124/80 and 128/76 mmHg;
    pulse,  82 beats/min 

What should be done to treat her dyslipidemia?

A. Add atorvastatin 10 mg daily
B. Add atorvastatin 10 mg daily and niacin SR 1000 mg twice daily
C. Add atorvastatin 10 mg daily and fenofibrate 160 mg daily
D. Add fenofibrate 160 mg daily
E. Encourage lifestyle modifications and continue current medications
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