A 72-year-old man with a 12-year history of type 2 diabetes mellitus was found to have carcinoma of the bladder. He was taking metformin; however, this was stopped because of his deteriorating renal function.
On examination, his weight was 95 kg and his body mass index was 32 kg/m2 (18C25).
Investigations:
serum sodium143 mmol/L (137C144)
serum potassium4.4 mmol/L (3.5C4.9)
serum creatinine175 µmol/L (60C110)
estimated glomerular filtration rate (MDRD)27 mL/min/1.73 m2 (>60)
haemoglobin A1c64 mmol/mol (20C42)
What is the most appropriate addition to his medication?
A . dapagliflozin
B . gliclazide
C . liraglutide
D . pioglitazone
E . sitagliptin
Answer: E