A 67-year-old woman with a 15-year history of type 2 diabetes presents for follow-up. She currently takes metformin 1000 mg twice daily and sitagliptin 100 mg daily. Her HbA1c is 8.1%, and her fasting glucose ranges from 10–12 mmol/L. She has coronary artery disease with a prior NSTEMI 3 years ago, and CKD stage 3B with an eGFR of 37 mL/min/1.73 m². BP is 122/68 mmHg. BMI is 31. She reports mild exertional dyspnea but no edema. She denies hypoglycemic episodes. She wants to avoid hypoglycemia and would like to lose weight. She is willing to use injections if the benefits are strong. Urine ACR is 38 mg/mmol (elevated).
Question 1 of 44
Which ONE of the following is the most appropriate next therapeutic step for this patient?
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