MSRA-0630

A 58-year-old man undergoes routine screening tests as part of his NHS health check. His results show an HbA1C level of 52 mmol/mol (<42), eGFR of >90 ml/min (>90), blood pressure of 130/84 mmHg, and a QRISK-3 score of 24.3%. After a repeat measurement, he is diagnosed with type 2 diabetes mellitus (T2DM) and decides to make lifestyle changes and take medication. However, he experiences significant gastrointestinal side effects with metformin, even after switching to a modified-release preparation.

What would be the most appropriate class of drug to switch to?