Recommendation
1:
ACP
recommends that clinicians prescribe metformin to patients with type
2 diabetes when pharmacologic therapy is needed to improve glycemic
control. (Grade: strong recommendation; moderate-quality evidence)
Recommendation
2:
ACP
recommends that clinicians consider adding either a sulfonylurea, a
thiazolidinedione, an SGLT-2 inhibitor, or a DPP-4 inhibitor to
metformin to improve glycemic control when a second oral therapy is
considered. (Grade: weak recommendation; moderate-quality evidence.)
ACP recommends that clinicians and patients select among medications
after discussing benefits, adverse effects, and costs.
Appendix
table 1 has a nice summary on outcomes.
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