Question

A 47-year-old with type 2 diabetes, A1c 8.6%, ASCVD, and eGFR 55 mL/min/1.73 m² already on metformin asks about next therapy. Best choice to reduce cardiovascular risk?

Accepted Answer

Add an SGLT2 inhibitor or GLP-1 receptor agonist with proven CV benefit

Answer

Increase metformin above 2000 mg/day

Answer

Add sulfonylurea first

Answer

Start basal insulin immediately

Answer

Pioglitazone as first add-on

Practice question

A 47-year-old with type 2 diabetes, A1c 8.6%, ASCVD, and eGFR 55 mL/min/1.73 m² already on metformin asks about next therapy. Best choice to reduce cardiovascular risk?