15th July 2024

A 37-year-old with type 1 diabetes attends a clinic for review. His current medication includes Ramipril

A 37-year-old with type 1 diabetes attends a clinic for review. His current medication includes Ramipril 10mg OD, Amlodipine and Bendroflumethiazide. His blood pressure is 135/80. He is a smoker of 20 per day and drinks 10 units of alcohol per week.  Blood tests taken today at the clinic show a creatinine of 250 micromol/L; this was 174 micromoles/L at last year’s review. HbA1c today is 55.

Which of the below strategies is most likely to delay further renal deterioration?

Select the SINGLE most appropriate option from the list below. Select ONE option only.