A 54-year-old man with long-standing type 2 diabetes attends annual review. His HbA1c is 70 mmol/mol (8.6%) despite maximum tolerated Metformin. He is...

Question

A 54-year-old man with long-standing type 2 diabetes attends annual review. His HbA1c is 70 mmol/mol (8.6%) despite maximum tolerated Metformin. He is overweight, with no established CVD and wishes to avoid weight gain. According to NICE type 2 diabetes guidance, which additional agent would be most appropriate?

Accepted Answer

Add an SGLT2 inhibitor with cardiovascular and renal benefit

Answer

Add a sulfonylurea as second-line

Answer

Add a DPP-4 inhibitor

Answer

Switch to insulin immediately as second-line

Answer

Start a thiazolidinedione without monitoring

uk-plab-1 MCQ (SBA): Type 2 diabetes – second-line therapy