Título Em Endocrinologia E Metabologia Practice Questions - TEEM - Título De Especialista Em Endocrinologia E Metabologia (SBEM AMB) Exam

Access More Questions

A 58-year-old male with a 7-year history of type 2 diabetes mellitus (T2DM), established coronary artery disease (post-CABG 3 years ago), and stage G3a diabetic kidney disease (eGFR 52 mL/min/1.73m², urine albumin-to-creatinine ratio [RAC] 180 mg/g) presents for routine follow-up. His current medications include metformin 1,000 mg twice daily, atorvastatin 40 mg, enalapril 20 mg daily, and carvedilol 25 mg twice daily. His HbA1c is 7.4% and blood pressure is 128/78 mmHg. According to the Sociedade Brasileira de Diabetes (SBD) and ADA/EASD consensus guidelines, what is the most appropriate next step in his glycemic and cardiorenal management?

Add glimepiride 2 mg daily to achieve an HbA1c target below 6.5%. Add an SGLT2 inhibitor (e.g., empagliflozin or dapagliflozin) or a GLP-1 receptor agonist with proven cardiorenal benefit, independent of baseline HbA1c. Discontinue metformin due to stage G3a CKD and initiate basal insulin glargine at bedtime. Add saxagliptin 5 mg daily as a DPP-4 inhibitor has proven superior cardiorenal mortality reduction.

Correct Answer:

Add an SGLT2 inhibitor (e.g., empagliflozin or dapagliflozin) or a GLP-1 receptor agonist with proven cardiorenal benefit, independent of baseline HbA1c.

Access more questions from this quiz

Continue to Título em Endocrinologia e Metabologia Practice Questions - TEEM - Título de Especialista em Endocrinologia e Metabologia (SBEM AMB) Exam for more practice questions and the full quiz experience.

Access More Questions