A 64-year-old woman with type 2 diabetes and established coronary artery disease has A1c 7.8 percent on metformin. eGFR is 62 mL/min/1.73 m2, urine

Question

A 64-year-old woman with type 2 diabetes and established coronary artery disease has A1c 7.8 percent on metformin. eGFR is 62 mL/min/1.73 m2, urine albumin-creatinine ratio is 18 mg/mmol, and BMI is 33 kg/m2. She has no history of pancreatitis. What is the most appropriate management?

Accepted Answer

Add an SGLT2 inhibitor or GLP-1 receptor agonist with cardiovascular benefit

Answer

Use sliding-scale insulin as outpatient monotherapy

Answer

Stop metformin because of coronary artery disease

Answer

Add glyburide as preferred cardiovascular therapy

Answer

Treat glycaemia without considering cardiovascular risk

Type 2 diabetes with ASCVD — RCPSC IM MCQ

A 64-year-old woman with type 2 diabetes and established coronary artery disease has A1c 7.8 percent on metformin. eGFR is 62 mL/min/1.73 m2, urine albumin-creatinine ratio is 18 mg/mmol, and BMI is 33 kg/m2. She has no history of pancreatitis. What is the most appropriate management?