Which Treatment First for Type 2 Diabetes?

December 4, 2014

In this unfortunately typical scenario, which medication would you choose as first-line treatment?

A 35-year-old woman with type 2 diabetes mellitus (T2DM) presents for follow-up. During a clinic visit 6 months ago, you advised weight loss, diet modification, and discussed the health consequences of persistent insulin resistance. Despite her best attempt, she has only lost 1% of her body weight. Her current BMI is 33 kg/m2. Her hemoglobin A1c is 8.

Which of the following medical treatments would you initiate?