You were wrong saying he has pre-diabetes. You're wrong about the "diagnostics on the pancreas" part. IF he changes his diet and lifestyle, and IF he loses weight he will find out if it can be reversed. You're wrong about his risk of DKA. Do you realize how many Type II diabetics are walking around right now with blood sugars in the 200s? I'd bet tens or hundreds of thousands in the US alone. Do you know how many are going to develop DKA? Almost none of them.