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Diabetic kidney disease — ABFM Board MCQ

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

ModerateEndocrine/MetabolicDiabetic kidney diseaseABFM Board

A 59-year-old woman with type 2 diabetes has an A1c of 7.1% and blood pressure of 136/82 mm Hg. Urine albumin-to-creatinine ratio is 110 mg/g on repeat testing; eGFR is 68. Which of the following is the most appropriate initial treatment?

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

Reveal the answer and explanation

Correct answer: B — Start an ACE inhibitor or angiotensin receptor blocker

Albuminuria in diabetes is treated with an ACE inhibitor or ARB, particularly with hypertension, to reduce kidney and cardiovascular risk.

Reference: ADA Standards of Care in Diabetes 2026: https://professional.diabetes.org/standards-of-care