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Metformin: Still best initial therapy for type 2 diabetes


Initial treatment with metformin compared with select oral antidiabetic agents for type 2 diabetes led to less treatment intensification and similar rates of hypoglycemia and other adverse clinical events, according to data from a retrospective cohort study published in JAMA Internal Medicine


Educate patients that metformin is a well-established first-line medication used for type 2 diabetes. A new analysis suggests that initial use of metformin compared with other oral agents resulted in a reduced need for subsequent add-on therapy. Help patients to understand, though, that treatment intensification is part of the normal progression of diabetes and should not be considered treatment failure.


Berkowitz SA et al. Initial choice of oral glucose-lowering medication for diabetes mellitus: a patient-centered comparative effectiveness study. JAMA Intern Med. 2014;[Epub ahead of print].

Segal JB et al. Initial therapy for diabetes mellitus. [commentary] JAMA Intern Med. 2014;[Epub ahead of print].