A 60-year-old woman with type 2 diabetes and established coronary artery disease has been on maximally tolerated metformin for 9 months. Her HbA1c rem...

Question

A 60-year-old woman with type 2 diabetes and established coronary artery disease has been on maximally tolerated metformin for 9 months. Her HbA1c remains 8.3 percent despite excellent adherence. Estimated glomerular filtration rate is 80 mL/min/1.73 m². According to Diabetes Canada, which additional agent is preferred to improve both glycaemic control and cardiovascular outcomes?

Accepted Answer

Add an SGLT2 inhibitor such as empagliflozin.

Answer

Add a sulfonylurea such as gliclazide.

Answer

Add a DPP-4 inhibitor such as sitagliptin.

Answer

Switch metformin to basal insulin only.

Answer

Add short-acting insulin with meals while stopping metformin.

ca-mccqe1 MCQ (SBA): Type 2 diabetes with cardiovascular disease