What class of medication should be considered for a 56-year-old female with T2DM and recent MI, presenting with an A1C of 7.5%?

In this scenario, the best choice for managing a 56-year-old female with type 2 diabetes mellitus (T2DM) and a recent myocardial infarction (MI) is an SGLT2 inhibitor. This class of medication has shown to provide cardiovascular benefits, which is particularly important for a patient with a history of MI. SGLT2 inhibitors work by promoting glucose excretion through the urine, leading to lower blood glucose levels. Additionally, they have been associated with weight loss and a reduction in blood pressure, which can further benefit patients with cardiovascular disease or those at high risk.

The use of SGLT2 inhibitors in patients with T2DM who have cardiovascular disease or are at high cardiovascular risk aligns with current clinical guidelines and evidence. Their renal protective effects also add to the overall health benefits in patients with diabetes, making them a suitable choice in this context.