Question

A 60-year-old man with type 2 diabetes has an HbA1c of 68 mmol/mol (8.4%) despite lifestyle interventions. According to NICE guidelines, which is typically the next pharmacological step?

Accepted Answer

Start metformin unless contraindicated

Answer

Start insulin therapy immediately

Answer

Add a sulfonylurea (e.g., gliclazide) to diet and exercise alone

Answer

Add a thiazolidinedione (e.g., pioglitazone) as first-line

Answer

Add a DPP-4 inhibitor (e.g., sitagliptin) as first-line

Practice question

A 60-year-old man with type 2 diabetes has an HbA1c of 68 mmol/mol (8.4%) despite lifestyle interventions. According to NICE guidelines, which is typically the next pharmacological step?