title: Clinical inquiries. What is the best medical therapy for new-onset type 2 diabetes?
abstract: 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).
authors.affiliation: Valley Family Medicine Residency, Renton, WA, USA.
authors.forename: Cheri
authors.initials: C
authors.lastname: Klam
authors.forename: Jon O
authors.initials: JO
authors.lastname: Neher
authors.forename: Helen
authors.initials: H
authors.lastname: Mayo
authors.forename: Vincent
authors.initials: V
authors.lastname: Lo
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents