A 35 year old woman with type 2 diabetes is seen in follow up. She is on metformin 1 g twice daily. Her HbA1c is 8.4% despite adherence, BMI 32 kg/m²,...

Question

A 35 year old woman with type 2 diabetes is seen in follow up. She is on metformin 1 g twice daily. Her HbA1c is 8.4% despite adherence, BMI 32 kg/m², eGFR 80 mL/min/1.73 m² and she has no established cardiovascular disease. According to Diabetes Canada, what is the most appropriate next step in pharmacologic management?

Accepted Answer

Add an SGLT2 inhibitor or GLP-1 receptor agonist considering weight and cardio renal profile

Answer

Add a DPP-4 inhibitor

Answer

Switch metformin to basal insulin only

Answer

Increase metformin dose

Answer

Stop metformin and manage with lifestyle alone

ca-mccqe1 MCQ (SBA): Type 2 diabetes mellitus