A 58 year old man with type 2 diabetes managed on Metformin alone has an HbA1c of 75 mmol/mol despite good adherence and lifestyle measures. According...

Question

A 58 year old man with type 2 diabetes managed on Metformin alone has an HbA1c of 75 mmol/mol despite good adherence and lifestyle measures. According to NICE guidance on type 2 diabetes in adults, which is the most appropriate next step in glycaemic management if there are no contraindications?

Accepted Answer

Add a Sulfonylurea such as Gliclazide

Answer

Stop Metformin and start Insulin

Answer

Add long acting insulin at night without other changes

Answer

Increase Metformin beyond the maximum tolerated dose

Answer

Switch to diet and exercise alone

uk-plab-1 MCQ (SBA): Type 2 diabetes stepwise therapy

A 58 year old man with type 2 diabetes managed on Metformin alone has an HbA1c of 75 mmol/mol despite good adherence and lifestyle measures. According to NICE guidance on type 2 diabetes in adults, which is the most appropriate next step in glycaemic management if there are no contraindications?