Did you dig into what prompted her concern wrt diabetic risk? Asking b/c a generic fasting glucose will flag ppl as pre diabetic at 100 mg/mL and that may be what she is responding to. Some pretty large employers will even offer annual testing for free and tell staff to follow up with pcp. If this pt is asian they may have read that the diabetic risk cutoff is at a bmi of 23. And of course there is family history.
Just some thoughts on how the messaging to laypeople can be very different than what warrants medical intervention. It must be frustrating to be so diligent and find that they are still at the threshold for "lifestyle intervention".