A 52-year-old man is newly diagnosed with type 2 diabetes mellitus after fasting plasma glucose of 8.5 mmol/L and HbA1c of 8.2%. He is overweight but ...

Question

A 52-year-old man is newly diagnosed with type 2 diabetes mellitus after fasting plasma glucose of 8.5 mmol/L and HbA1c of 8.2%. He is overweight but otherwise healthy with eGFR 80 mL/min/1.73 m². According to Diabetes Canada pharmacologic guidelines, what is the most appropriate initial management?

Accepted Answer

Start metformin in addition to lifestyle modification

Answer

Lifestyle modification only for 6 months, then reassess

Answer

Start metformin plus basal insulin immediately

Answer

Start a sulfonylurea as first-line pharmacotherapy

Answer

Start an SGLT2 inhibitor as monotherapy

ca-mccqe1 MCQ (SBA): Initial pharmacologic management of type 2 diabetes