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Type 2 diabetes with ASCVD — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareType 2 diabetes with ASCVDUSMLE Step 3

A 63-year-old man with type 2 diabetes takes metformin and atorvastatin. A1c is 7.4%, eGFR is 72 mL/min/1.73 m2, and he had myocardial infarction 2 years ago. He has no pancreatitis history or recurrent genital infections. He asks about reducing future cardiac risk. Which of the following would you recommend at the follow-up visit?

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

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Correct answer: A — Add an SGLT2 inhibitor or GLP-1 receptor agonist with cardiovascular benefit

Patients with type 2 diabetes and established ASCVD benefit from SGLT2 inhibitors or GLP-1 receptor agonists with proven cardiovascular benefit.

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