A 58-year-old woman with type 2 diabetes mellitus has an HbA1c of 8.5% despite being on metformin 1000 mg twice daily. She has a history of atherosclerotic cardiovascular disease and obesity (BMI 34 kg/m²). Her renal function is normal. Which of the following medications would be the most appropriate addition to her current regimen?

The correct answer to the question "A 58-year-old woman with type 2 diabetes mellitus has an HbA1c of 8.5% despite being on metformin 1000 mg twice daily. She has a history of atherosclerotic cardiovascular disease and obesity (BMI 34 kg/m²). Her renal function is normal. Which of the following medications would be the most appropriate addition to her current regimen?" is Option C: Liraglutide (GLP-1 receptor agonist).

The other options — A) Glipizide (sulfonylurea), B) Insulin glargine, D) Pioglitazone (thiazolidinedione) — are incorrect for this USMLE Exam Prep question. As explained above: For patients with type 2 diabetes and established atherosclerotic cardiovascular disease, GLP-1 receptor agonists (like liraglutide) and SGLT2 inhibitors are recommended as second-line agents due to …