A 59-year-old man with type 2 diabetes takes metformin. His A1c is 7.6%, eGFR is 62 mL/min/1.73 m2, and urine albumin-creatinine ratio is 190 mg/g.

Question

A 59-year-old man with type 2 diabetes takes metformin. His A1c is 7.6%, eGFR is 62 mL/min/1.73 m2, and urine albumin-creatinine ratio is 190 mg/g. Blood pressure is controlled with lisinopril. He has no genitourinary symptoms. Which of the following would you recommend at the follow-up visit?

Accepted Answer

Add an SGLT2 inhibitor

Answer

Add glyburide

Answer

Stop lisinopril

Answer

Add niacin

Answer

Start basal insulin as monotherapy

Type 2 diabetes with chronic kidney disease — USMLE Step 3 MCQ

A 59-year-old man with type 2 diabetes takes metformin. His A1c is 7.6%, eGFR is 62 mL/min/1.73 m2, and urine albumin-creatinine ratio is 190 mg/g. Blood pressure is controlled with lisinopril. He has no genitourinary symptoms. Which of the following would you recommend at the follow-up visit?