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Metformin in CKD — PSA MCQ

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HardEndocrinologyMetformin in CKDPSAMRCGP AKTMRCP Part 1UKMLAPARA

A woman with type 2 diabetes takes metformin 1 g twice daily. Her stable eGFR is 32 mL/min/1.73 m². What is the most appropriate prescribing response?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Review metformin dose and renal function

At eGFR 30 to 44, metformin requires dose review and closer renal monitoring; it is not automatically continued unchanged. It should not be used below eGFR 30. The broader glucose-lowering plan should reflect glycaemia, comorbidity and hypoglycaemia risk.

Reference: NICE NG28: Type 2 diabetes in adults: https://www.nice.org.uk/guidance/ng28/chapter/recommendations