Treating Type 2 Diabetes with ASCVD
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Treating Type 2 Diabetes with ASCVD
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A 60-year-old male with documented ASCVD, obesity with BMI of 34, and type 2 diabetes presents for care. The patient reports he's currently feeling well without episodes of hypoglycemia. Current laboratory assessment includes the following. A1C is 8.6 % and his estimated GFR is at 62. Current medications include metformin at optimized dose and a sulfonyl urea.
Which of the following represents the nurse practitioner's next best action?
A. continue on current therapy and arrange for a three month follow up
B. discontinue the metformin and add a DPP4 inhibitor
C. add a GLP-1 inhibitor and discontinue the sulfonyl urea
D. add basal insulin and titrate to fasting glycemic goals
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