Therapy Evaluation: T2DM, HTN, Dyslipidaemia, CKD

The NP is caring for a 68 year-old man with a 20 year-history of  type 2 DM, HTN, dyslipidaemia, obesity (BMI=32 kg/m2) stage 3a CKD who is currently taking all of the following medications at optimized doses and with adherence, ACEI, thiazide diuretic, statin, and metformin. His current A1c= 8.2%. (NL= <5-6%)  and states he is feeling well. Which of the following should be considered as next step therapy?

A. A sulfonylurea

B. Basal insulin

C. A SGLT2- inhibitor 

D. No additional therapy as he is feeling well.

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