What is the appropriate next step for Jenny regarding her elevated fasting blood sugar level?

When considering the management of an elevated fasting blood sugar level, the most logical next step is to repeat the fasting blood sugar test and to check an HbA1c. This approach helps to confirm the initial finding, as single elevated fasting glucose levels can result from transient factors such as stress, illness, or medication effects.

Repeating the fasting blood glucose provides clarity on whether the elevation is consistent or an anomaly. The addition of an HbA1c test is crucial because it reflects long-term glycemic control over the past two to three months, offering a broader view of Jenny's glucose metabolism.

In contrast, discontinuing hydrochlorothiazide may not address the underlying issue of elevated blood sugar, especially if the medication is essential for her other health conditions. Ordering a glucose tolerance test might be an option, but it is not typically the immediate next step if fasting blood sugar is already confirmed to be elevated; it's often used during screening when there's uncertainty in diagnosis. Starting insulin therapy would be premature in this scenario, as it requires a confirmed diagnosis of diabetes and is not the first-line approach without further confirmation of the condition. Therefore, the chosen option of repeating the fasting blood sugar and doing an HbA1c provides the necessary data to guide further management