A 48-year-old man with obesity (BMI 33 kg/m²) is found to have fasting plasma glucose 8.6 mmol/L on two separate occasions. HbA1c is 7.9%. He has no e...

Question

A 48-year-old man with obesity (BMI 33 kg/m²) is found to have fasting plasma glucose 8.6 mmol/L on two separate occasions. HbA1c is 7.9%. He has no established cardiovascular disease and normal renal function. According to Diabetes Canada, what is the most appropriate initial pharmacologic management in addition to lifestyle measures?

Accepted Answer

Start metformin monotherapy

Answer

Start basal insulin once daily

Answer

Start a sodium-glucose cotransporter-2 (SGLT2) inhibitor monotherapy

Answer

Start combination metformin plus basal insulin

Answer

No pharmacologic therapy is indicated at this stage

ca-mccqe1 MCQ (SBA): Type 2 diabetes mellitus