Managing patients with type 2 diabetes: Test your skills with these 5 questions
Author and Disclosure Information [Show]

Gary S. Ferenchick, MD, MS, FACP, is a Professor of Internal Medicine at Michigan State University, East Lansing. Dr. Ferenchick is also a faculty member of the National Family Medicine Board Review course and creator of www.justintimemedicine.com.

Question 1 of 5

A 71-year-old man with known coronary artery disease (CAD) comes to your office for a routine visit. He was diagnosed with CAD 17 years ago after experiencing an anterior wall myocardial infarction (MI) requiring 4 stents in the left anterior descending (LAD) artery. His ejection fraction has remained at 60% since his MI. Other history includes asthma, hypertension (HTN), and type 2 diabetes (T2D). He says he has no symptoms of chest pain, palpitations, or shortness of breath with exertion, or T2D-related end-organ symptoms.

He is currently taking amlodipine 5 mg/d, aspirin 81 mg/d, losartan 25 mg/d, metoprolol 12.5 mg bid, rosuvastatin 10 mg/d, and extended-release metformin 2000 mg/d. He takes his medications as prescribed, is following a heart-healthy diet, and does not smoke.

His low-density lipoprotein (LDL) cholesterol concentration is 67 mg/dL. Last year, his hemoglobin A1C was 6.1%, and this year, it is 6.7%. His estimated glomerular filtration rate (eGFR) is 70 mL/min/1.73m2. His physical examination is unremarkable.

The next most appropriate step in this patient’s pharmacologic management is to add:

Basal insulin 10 units/d.

Sitagliptin 50 mg/d (a dipeptidyl peptidase-IV [DPP-IV] inhibitor).

Empagliflozin 10 mg (a sodium-glucose cotransporter-2 [SGLT2] inhibitor).

Glimepiride 1 mg (a sulfonylurea).

This quiz is not accredited for CME.

More from Residents' Rapid Review

QUIZ

Iron-deficiency anemia: Test your skills with these 5 questions
Update on psoriasis: Test your skills with these 5 questions
Pediatric developmental milestones: Test your skills with these 5 questions
Upper gastrointestinal issues: Test your skills with these 5 questions
Monkeypox virus: Test your skills with these 5 questions
Opioid Use Disorder: Diagnosis and treatment: Test your skills with these 5 questions
Heart failure: Test your skills with these 5 questions
Electrolytes: Test your skills with these 5 questions
Endocrine issues: Test your skills with these 5 questions
Adult immunization update: Test your skills with these 5 questions
COPD evaluation and treatment: Test your skills with these 5 questions
Asthma and COPD: Test your skills with these 5 questions
Exercise preparticipation examinations: Test your skills with these 5 questions
EKG challenge: Test your skills with these 5 questions
Early pregnancy loss (EPL): Test your skills with these 5 questions
Nontraumatic musculoskeletal pain: Test your skills with these 5 questions
US Preventive Services Task Force (USPSTF) recommendations: Test your skills with these 5 questions
Ingestions and poisoning: Test your skills with these 5 questions
Gonococcal infections: Test your skills with these 5 questions
Thyroid nodules and hypothyroidism treatment: Test your skills with these 5 questions
Acute complications during pregnancy: Test your skills with these 5 questions
Back pain: Test your skills with these 5 questions
Heart failure: Test your skills with these 5 questions
COVID-19: Test your skills with these 5 questions
Gastrointestinal bleeding & dyspepsia: Test your skills with these 5 questions
Obesity: Test your skills with these 5 questions
Pediatric emergencies: Test your skills with these 5 questions
Electrocardiogram interpretation: Test your skills with these 5 questions
Hepatitis C: Test your skills with these 5 questions
Hypertension: Test your skills with these 5 questions
Abnormal uterine bleeding: Test your skills with these 5 questions
Management of surgical patients: Test your skills with these 5 questions
Hyperlipidemia: Test your skills with these 5 questions
Drug topics in primary care: Test your skills with these 5 questions
Recurrent headaches: Test your skills with these 5 questions
Dermatology: Test your skills with these 5 questions
Gastrointestinal disorders: Test your skills with these 5 questions
Orthopedics-Sports Medicine: Test your skills with these 5 questions
Osteoarthritis: Test your skills with these 5 questions
Geriatrics: Test your skills with these 5 questions
CVD risk management: Test your skills with these 5 questions
Gastrointestinal disorders: Test your skills with these 5 questions
Animal bites and envenomations: Test your skills with these 5 questions
Hyperthyroidism: Test your skills with these 5 questions
Sexually transmitted infections: Test your skills with these 5 patients
Gout: Test your skills with these 5 patients
Type 2 diabetes mellitus: Test your skills with these 3 patients
Surgery—postoperative complications and common problems
Pollution
Pediatrics
Dermatology
Atrial fibrillation
Orthopedic/sports medicine
Cigarette smoking
Gastrointestinal
Obstetrics
Alcohol misuse
Fluids and electrolytes