A 58-year-old man with type 2 diabetes and an eGFR of 48 mL/min/1.73m² presents for medication review. His HbA1c is 8.2%. Which antidiabetic drug class has demonstrated cardiovascular AND renoprotective benefit independent of glycemic control in this patient?

• A Dipeptidyl peptidase-4 inhibitors (gliptins)
• B Sulfonylureas (glimepiride)
• C Alpha-glucosidase inhibitors (acarbose)
• D Sodium-glucose cotransporter-2 inhibitors (SGLT2i) ✓

Explanation

SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) have demonstrated robust cardiovascular and renoprotective benefits independent of glycemic control in trials such as EMPA-REG OUTCOME, DAPA-HF, CREDENCE, and DAPA-CKD. DPP-4 inhibitors are CV-neutral with no proven renal benefit. Sulfonylureas increase hypoglycemia risk and have no organ-protective effects. Acarbose only reduces postprandial hyperglycemia.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.