Clinical inquiries. What is the best medical therapy for new-onset type 2 diabetes?
Sulfonylureas, metformin, thiazolidinediones, and non-sulfonylurea secretagogues differ little in their ability to decrease glycosylated hemoglobin (Hb A1c) levels when used as initial monotherapy for diabetes mellitus type 2 (strength of recommendation [SOR]: A, based on systematic reviews); alpha-glucosidase inhibitors may also be as effective (SOR: B, based on systematic reviews with inconsistent results). Metformin is generally indicated in obese patients because it improves all-cause mortality and diabetes related outcomes (SOR: B, based on a single high-quality randomized controlled trial [RCT]). Insulin is generally not recommended as an initial agent (SOR: C, expert opinion).
Klam
Cheri
C
Valley Family Medicine Residency, Renton, WA, USA.
Neher
Jon O
JO
Mayo
Helen
H
Lo
Vincent
V
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*
D007004:Hypoglycemic Agents