Question

A 62-year-year-old man with BMI 31 and A1c 8.4% on metformin asks about starting basal insulin vs GLP-1 RA. He declines injections for now. ADA guidance?

Accepted Answer

Add GLP-1 RA with CV benefit if willing; otherwise consider additional oral agents

Answer

Start SU first-line instead

Answer

Basal insulin mandatory at A1c >8

Answer

No therapy change

Answer

Add DPP-4 inhibitor only

Practice question

A 62-year-year-old man with BMI 31 and A1c 8.4% on metformin asks about starting basal insulin vs GLP-1 RA. He declines injections for now. ADA guidance?