MRCP2-1443

MRCP2-1443

A 72-year-old man comes to the clinic for a follow-up appointment. He was recently diagnosed with type 2 diabetes after his GP conducted a screening. Despite being advised on dietary changes, his HbA1c levels have not improved. The patient has a medical history of bladder cancer, which was treated with chemotherapy, hypertension, macular degeneration, eczema, and chronic kidney disease. His baseline eGFR is 28 ml/min/1.73m2.

Lab results:
– Na+ 139 mmol/l
– K+ 4.4 mmol/l
– Urea 6.2 mmol/l
– Creatinine 214 µmol/l

What medication would be the most appropriate to initiate?