Question

A 64-year-old man with type 2 diabetes on maximum tolerated Metformin has HbA1c 75 mmol/mol (9.0%). He has established cardiovascular disease. eGFR is 65 mL/min/1.73 m². What is the most appropriate next step?

Accepted Answer

Add an SGLT2 inhibitor with proven cardiovascular benefit

Answer

Add a sulfonylurea alone

Answer

Switch Metformin to insulin immediately

Answer

Add a thiazolidinedione as first choice

Answer

Do nothing and repeat HbA1c in 12 months

Practice question

A 64-year-old man with type 2 diabetes on maximum tolerated Metformin has HbA1c 75 mmol/mol (9.0%). He has established cardiovascular disease. eGFR is 65 mL/min/1.73 m². What is the most appropriate next step?