Type 2 diabetes with renal impairment: prescribing an antidiabetic agent
Write a prescription for type 2 diabetes mellitus with renal impairment and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.
medium8 scoring rulesrenal impairment
- Patient
- 65 years, male, 80 kg
- Diagnosis
- Type 2 diabetes mellitus with renal impairment
- Renal function
- eGFR 25 mL/min/1.73m²
- Allergies
- None known
The scenario
Patient B-217 is a 65-year-old man with type 2 diabetes mellitus diagnosed 4 years ago. He has been managed with diet and exercise alone, but his glycaemic control has worsened over the past year. He presents for a routine diabetes review. He is asymptomatic. Examination is unremarkable; blood pressure is 136/78 mmHg. His recent HbA1c is 9.2%. He has chronic kidney disease stage 4, with an eGFR of 25 mL/min/1.73 m² and serum creatinine 230 µmol/L. He is not taking any antidiabetic medication. He asks for medication to lower his blood glucose. Choose an appropriate antidiabetic agent for this patient.
What gets marked
- Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
- Dose, route, frequency and duration against the range for this patient.
- Renal and hepatic dose adjustment where this patient's numbers demand it.
- Allergy cross-reactivity and interactions with the medicines already on the chart.
- The instructions and monitoring you write, not only the drug you pick.
8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.
Log in to prescribe for "Type 2 diabetes with renal impairment: prescribing an antidiabetic agent"
A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.