A 58-year-old man with type 2 diabetes, obesity and hypertension has an HbA1c of 70 mmol/mol (8.6%) despite maximally tolerated metformin. eGFR is 70 ...

Question

A 58-year-old man with type 2 diabetes, obesity and hypertension has an HbA1c of 70 mmol/mol (8.6%) despite maximally tolerated metformin. eGFR is 70 mL/min/1.73 m². He has albuminuria and a 5-year absolute CVD risk of 18%. Which additional glucose-lowering agent is preferred to improve both glycaemic control and cardiovascular-renal outcomes?

Accepted Answer

SGLT2 inhibitor

Answer

Sulfonylurea (e.g. gliclazide)

Answer

DPP-4 inhibitor

Answer

Thiazolidinedione

Answer

Basal insulin as immediate second line

au-amc MCQ (SBA): Type 2 diabetes with high cardiovascular risk