A 56-year-old man comes to the physician for evaluation of gradually worsening fatigue, increased urinary frequency, and blurry vision for 5 months. The patient was diagnosed 4 years ago and was initially managed with metformin. Physical examination shows decreased vibratory sense and proprioception in the lower extremities. His hemoglobin A1c is 10.4%. he patient does not want to take insulin or other injectable diabetic medications. After discussing various treatment options, canagliflozin is added to his current regimen. Which of the following tests should be ordered prior to initiating the new therapy in this patient?

Question

A 56-year-old man comes to the physician for evaluation of gradually worsening fatigue, increased urinary frequency, and blurry vision for 5 months. The patient was diagnosed 4 years ago and was initially managed with metformin. Physical examination shows decreased vibratory sense and proprioception in the lower extremities. His hemoglobin A1c is 10.4%. he patient does not want to take insulin or other injectable diabetic medications.  After discussing various treatment options, canagliflozin is added to his current regimen.  Which of the following tests should be ordered prior to initiating the new therapy in this patient?

Quizplus · Accepted Answer

Eductional Objective: Sodium-glucose cotransporter 2 inhibitors (eg, canagliflozin, dapagliflozin) decrease renal reabsorption of glucose, leading to urinary glucose loss and decreased blood glucose levels.  In patients with chronic kidney disease, these medications are less effective.  Therefore, serum creatinine should be measured prior to therapy.

A 56-Year-Old Man Comes to the Physician for Evaluation of Gradually