Question

A 65-year-old with type 2 diabetes, eGFR 30 mL/min/1.73 m², and urine albumin-to-creatinine ratio 600 mg/g is on metformin and a maximally tolerated ACE inhibitor. BP is at goal. What is the most appropriate glycaemic agent to add to slow CKD progression?

Accepted Answer

Add a sodium-glucose cotransporter-2 (SGLT2) inhibitor

Answer

Add a sulfonylurea

Answer

Add a thiazolidinedione

Answer

Add a dipeptidyl peptidase-4 (DPP-4) inhibitor

Answer

Switch ACE inhibitor to ARB

Practice question

A 65-year-old with type 2 diabetes, eGFR 30 mL/min/1.73 m², and urine albumin-to-creatinine ratio 600 mg/g is on metformin and a maximally tolerated ACE inhibitor. BP is at goal. What is the most appropriate glycaemic agent to add to slow CKD progression?