29th May 2025

A 55-year-old male with recently diagnosed type 2 diabetes mellitus presents for a follow-up appointment.

A 55-year-old male with recently diagnosed type 2 diabetes mellitus presents for a follow-up appointment. He is currently only taking metformin, his HbA1c is measured at 53 mmol/L. Screening reveals an albumin-creatinine ratio (ACR) of 25mg/mmol on two separate occasions. His estimated glomerular filtration rate (eGFR) is currently 70 ml/min/1.73m^2. What is the most appropriate initial management for this patient with early diabetic kidney disease (DKD)?

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