A 55-year-old patient with type 2 diabetes mellitus has an HbA1c of 68 mmol/mol (8.4%) despite lifestyle modifications and metformin at the maximum to...

Question

A 55-year-old patient with type 2 diabetes mellitus has an HbA1c of 68 mmol/mol (8.4%) despite lifestyle modifications and metformin at the maximum tolerated dose. According to NICE, what is the best next step in medication management?

Accepted Answer

Add a sulfonylurea (e.g. gliclazide)

Answer

Add a DPP-4 inhibitor (e.g. sitagliptin) and a thiazolidinedione (e.g. pioglitazone) together

Answer

Switch to insulin therapy immediately

Answer

Add an SGLT2 inhibitor (e.g. canagliflozin) alone

Answer

Add insulin secretagogues only if BMI

NICE Type 2 Diabetes Guideline MCQ (SBA): Type 2 Diabetes Mellitus

A 55-year-old patient with type 2 diabetes mellitus has an HbA1c of 68 mmol/mol (8.4%) despite lifestyle modifications and metformin at the maximum tolerated dose. According to NICE, what is the best next step in medication management?