skip to main content

T2DM – metformin — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEndocrineT2DM – metforminRACP Paediatrics

A 15-year-old obese adolescent (BMI 35) with acanthosis nigricans is diagnosed with type 2 diabetes (HbA1c 62 mmol/mol, fasting glucose 8.5 mmol/L, negative GAD/IA-2 antibodies). There is no ketonuria. What is the most appropriate initial pharmacological therapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Metformin

Metformin is the first-line pharmacological therapy for type 2 diabetes in adolescents, combined with lifestyle modification (diet and exercise). If HbA1c remains >69 mmol/mol or ketonuria is present at diagnosis, insulin may be needed initially. GLP-1 agonists are emerging as adjunctive therapy in adolescents.

Reference: RCH Melbourne – 2023 – Type 2 Diabetes CPG; ISPAD – 2022 – T2DM Guidelines