Intra-articular corticosteroids would the most appropriate treatment given the patients history of diabetes and renal insufficiency. While indomethacin is the traditional first-line agent, the patients age, renal insufficiency, and hypertension would make it a less desirable choice. Colchicine is also a traditional choice, but patients renal insufficiency, complicated administration schedule, and risk of side effects would not make it a first option. Allopurinol does not treat an acute attack of gout and, in fact, may worsen it.
- Intra-articular corticosteroids.
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