A 79-year-old woman diagnosed with T2DM and microalbuminuria is currently symptom-free. What is the most appropriate drug management?

In managing a 79-year-old woman with type 2 diabetes mellitus (T2DM) and microalbuminuria, the primary focus should be on cardiovascular protection and renal health. Microalbuminuria indicates early renal impairment, which is a common concern in patients with diabetes.

The appropriate drug management that includes both a statin and an ACE inhibitor addresses two key areas:

1. Statin Therapy: Statins are recommended for nearly all patients with diabetes over the age of 40 due to their ability to lower LDL cholesterol and reduce the risk of cardiovascular events, which is particularly crucial as older patients with diabetes have an increased risk of heart disease.

2. ACE Inhibitor: The use of an ACE inhibitor is vital for patients with microalbuminuria. These medications not only help manage blood pressure but also have a renoprotective effect, slowing the progression of kidney disease in diabetic patients.

Combining statins and ACE inhibitors effectively addresses both the cardiovascular and renal risks associated with diabetes, especially in older patients, making this option the most appropriate for the patient described.

While glibenclamide (a sulfonylurea) and metformin are both antidiabetic drugs, their primary role