56-year-old type 2 DM patient on metformin, NPH and enalapril presented with bilateral leg swelling of 2 weeks duration. BP-150/90, 5Cr-3.4mg/dl and K+= 6.5 ECG shown peaked T waves. What is the next initial step in management? A Hold metformin and enalapril B. Give Calcium gluconate 1096 C. Intravenous Lasix D. Repeat serum electrolyte and RFT

Since the 56-year-old type 2 DM patient on metformin, NPH and enalapril presented with bilateral leg swelling of 2 weeks duration, the next initial step in management is option D. Repeat serum electrolyte and RFT.Does metformin have an impact on kidney function?In individuals with intermediate CKD, metformin-associated lactic acidosis can result in metabolic acidosis, which has been demonstrated to have a negative impact on renal function and accelerate the progression of CKD [17–19].Therefore, Every three to six months, fasting blood sugar, postprandial blood sugar, and hemoglobin A1C (HbA1c) levels are monitored for any oral antidiabetic medications. Long-term metformin use has been linked sporadically to vitamin B12 insufficiency. Learn more about metformin fromhttps://brainly.com/question/4158204#SPJ1