Which management option is most appropriate for a 45-year-old man with colon cancer and a fasting blood glucose of 9 mmol/L?

In this scenario, the most appropriate management option for the 45-year-old man with colon cancer and a fasting blood glucose of 9 mmol/L is the use of oral hypoglycaemics. This is an effective choice for treating type 2 diabetes, which is indicated by his elevated fasting glucose level. Oral antidiabetic medications can be introduced to help manage blood glucose levels without necessitating injections, making them a practical first-line option for many patients.

Considering the patient's context, including his cancer diagnosis, it’s essential to manage his blood glucose in a way that balances treatment with his overall health condition and potential limitations on his physical health and dietary habits. Oral hypoglycaemics can often be effective and easier for patients to manage, especially in terms of adherence compared to insulin therapy.

Long-acting insulin may not be the first-line choice given that his fasting glucose may still be manageable with oral medications. IV insulin is typically reserved for acute settings, such as emergency hyperglycemic states or hospital settings where immediate glucose control is crucial. Short-acting insulin before meals, while beneficial for controlling postprandial glucose spikes, may not address the overall management effectively for an individual who is not yet on insulin therapy.