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Consider the following case scenarios. All of the following patients are on metformin 2g/day and need to step up treatment. The different options have been discussed, and they are ready to make a decision. Using the individualised approach recommended in the guidelines (NICE, ADA/EASD) and the characteristics of each drug class described above, select the option that you believe to be most appropriate. Refer to the SmPC for each product for further information.

Stephen, age 42; HbA1c 58 mmol/mol; BMI 42 m/kg2; eGFR 54ml/min/1.73m2; works shifts as a railway engineer. What would you recommend as a next step?

(Please select 1 option)

A sulfonylurea
DPP-4 inhibitor
GLP-1 RA
SGLT2 inhibitor
Insulin

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