Question

A 58-year-old with T2DM, eGFR 35 mL/min/1.73 m², and urine albumin-creatinine ratio 450 mg/g is on maximally tolerated ACE inhibitor. Next disease-modifying step?

Accepted Answer

Begin SGLT2 inhibitor if not contraindicated

Answer

Switch ACE inhibitor to ARB

Answer

Add thiazide diuretic for BP only

Answer

Start sulfonylurea

Answer

Add basal insulin regardless of A1C

Practice question

A 58-year-old with T2DM, eGFR 35 mL/min/1.73 m², and urine albumin-creatinine ratio 450 mg/g is on maximally tolerated ACE inhibitor. Next disease-modifying step?