A 58-year-old woman with type 2 diabetes managed on Metformin 1 g twice daily has a persistently elevated HbA1c of 72 mmol/mol despite good adherence....

Question

A 58-year-old woman with type 2 diabetes managed on Metformin 1 g twice daily has a persistently elevated HbA1c of 72 mmol/mol despite good adherence. She has established cardiovascular disease. What is the most appropriate next pharmacological step according to current guidance?

Accepted Answer

Add an SGLT2 inhibitor with proven cardiovascular benefit

Answer

Stop Metformin and start Gliclazide alone

Answer

Add a thiazolidinedione such as Pioglitazone as first choice

Answer

Add basal human insulin as the next step

Answer

Stop Metformin and manage with lifestyle measures only

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

A 58-year-old woman with type 2 diabetes managed on Metformin 1 g twice daily has a persistently elevated HbA1c of 72 mmol/mol despite good adherence. She has established cardiovascular disease. What is the most appropriate next pharmacological step according to current guidance?