Question

A 65-year-old man with type 2 diabetes and a prior ST-elevation myocardial infarction is followed in internal medicine clinic. He is on metformin 1 g twice daily with HbA1c 7.5%, eGFR 55 mL/min/1.73 m², and no history of ketoacidosis. According to Diabetes Canada, which additional antihyperglycaemic strategy is most appropriate to reduce his cardiovascular risk?

Accepted Answer

Add an SGLT2 inhibitor with demonstrated cardiovascular benefit

Answer

Add a sulfonylurea to improve glycaemic control

Answer

Add a DPP-4 inhibitor because of his eGFR

Answer

Switch metformin to basal insulin

Answer

Make no change because his HbA1c is already at target

Practice question