Type 2 diabetes with ASCVD — MCCQE Part 1 MCQ
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Correct answer: D — Add an SGLT2 inhibitor or GLP-1 receptor agonist with cardiovascular benefit
Add an SGLT2 inhibitor or GLP-1 receptor agonist with cardiovascular benefit is the single best answer because the age, timing, examination findings and investigations in the vignette fit Type 2 diabetes with ASCVD better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Diabetes Canada CPG 2024 update, with attention to acuity, safety-netting and local provincial pathways.
Reference: Diabetes Canada CPG 2024 update