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Type 2 Diabetes with CKD — SCE Endocrinology MCQ

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ModerateEndocrinologyType 2 Diabetes with CKDSCE Endocrinology

A 61-year-old with T2DM and A1c 9.2% is on metformin and basal insulin. CKD stage 3a (eGFR 52). Which non-insulin agent has proven CV and renal benefits and is appropriate?

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Correct answer: A — Add SGLT2 inhibitor if eGFR ≥20 mL/min/1.73 m²

ADA and KDIGO recommend SGLT2 inhibitors for patients with diabetes and CKD (eGFR ≥20) to improve CV and renal outcomes. Sulfonylureas and DPP-4 inhibitors lack robust CV/renal benefit; SGLT2s are not contraindicated at this eGFR; TZDs are not preferred for CV/renal benefit.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions