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Metformin renal impairment — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin renal impairmentGPhC CRA

A patient with type 2 diabetes takes semaglutide and sitagliptin together after medicines were added by separate clinics. What should the pharmacist recommend?

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Correct answer: B — Review sitagliptin; dual incretin therapy offers little additional benefit

GLP-1 receptor agonists and DPP-4 inhibitors act on the same incretin pathway, and NICE’s 2026 review concluded that combining them adds no useful value. The duplicate incretin strategy should be reconciled while preserving the medicine selected for the patient’s comorbidity and glycaemic goals.

Reference: NICE NG28: type 2 diabetes — reviewing medicines: https://www.nice.org.uk/guidance/ng28/chapter/Reviewing-medicines