According to the Joint British Diabetes Societies Guidelines (2012), what is the most appropriate next hypoglycaemic agent?

A 72-year-old man with a dense residual hemiparesis and unsafe swallow was fed via a percutaneous gastrostomy for 20 hours each day. He had type 2 diabetes mellitus that had been well controlled with metformin.

His glucose levels were uncontrolled on metformin powder at maximum dose.

According to the Joint British Diabetes Societies Guidelines (2012), what is the most appropriate next hypoglycaemic agent?
A . exenatide
B . gliclazide
C . insulin detemir
D . insulin glargine
E . premixed (30/70) human insulin

Answer: E

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