A 67-year-old woman is seen for follow-up of type 2 diabetes diagnosed 15 years ago. She had a non-ST-elevation myocardial infarction 3 years ago and has mild exertional dyspnea without edema or orthopnea; one year ago she was hospitalized for necrotizing fasciitis of the perineum (Fournier gangrene) while taking canagliflozin, which was permanently stopped. She wants to lose weight, wants to avoid hypoglycemia, and is willing to inject a medication if the benefit is clear, and she has no personal or family history of thyroid cancer or pancreatitis and no known drug allergies. Current medications are metformin 1000 mg BID, sitagliptin 50 mg daily, ramipril, atorvastatin and ASA, and her BMI is 31 kg/m2. HbA1c is 8.1% (4.0-6.0) and eGFR is 37 mL/min/1.73 m2 (greater than 60).
| Heart rate | 74/min |
| Blood pressure | 122/68 mm Hg |
Question 1 of 27
Which of the following are the most appropriate changes to her medications at this visit?
Select 2. (0 / 2 selected)
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