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    Subjects/Pathology/Diabetes Mellitus Pathology
    Diabetes Mellitus Pathology
    medium
    microscope Pathology

    A 38-year-old woman with type 2 diabetes mellitus for 8 years presents with progressive dyspnea, orthopnea, and lower limb edema. On examination, she has elevated JVP, hepatomegaly, and bilateral ankle edema. Echocardiography reveals left ventricular ejection fraction (LVEF) of 35% with restrictive filling pattern. She is currently on metformin 1000 mg BD and glibenclamide 5 mg BD. Blood pressure is 145/92 mmHg. What is the most appropriate next step in management?

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