Question

A 56-year-old woman with type 2 diabetes on metformin 1 g twice daily has an eGFR of 38 mL/min/1.73 m², BMI 33 kg/m², HbA1c 64 mmol/mol despite lifestyle optimisation. She has established atherosclerotic cardiovascular disease. The best next pharmacological step is:

Accepted Answer

Add an SGLT2 inhibitor with proven CV benefit

Answer

Add a DPP-4 inhibitor

Answer

Switch metformin to gliclazide

Answer

Add basal insulin

Answer

Stop metformin immediately due to eGFR 38

Practice question

A 56-year-old woman with type 2 diabetes on metformin 1 g twice daily has an eGFR of 38 mL/min/1.73 m², BMI 33 kg/m², HbA1c 64 mmol/mol despite lifestyle optimisation. She has established atherosclerotic cardiovascular disease. The best next pharmacological step is: