Research
Hormonal
Metformin is the first-line pharmacological treatment for T2DM and prediabetes, offering significant reduction in microvascular complications and diabetes-related deaths through mechanisms including inhibition of hepatic gluconeogenesis and increased insulin sensitivity.
Metformin is the standard first-line drug for T2DM and prediabetes. It reduces complications and deaths. If you experience stomach upset, ask your doctor about slow-release versions or slow titration to manage side effects.
StrongSupportsVERY_HIGH confidence
It is the first drug recommended by all guidelines for the treatment of T2DM and the prevention of overt diabetes among the high-risk prediabetes population [49].
Why this rating
Supported by UKPDS, 10-year follow-up, and meta-analyses cited.
Source
Management of Type 2 Diabetes Mellitus
Leslie Bahn Kawa · IntechOpen eBooks · 2023
DOI 10.5772/intechopen.1002478
book_chapterCited 5×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- SGLT2 receptor inhibitors (SGLT2R-i) provide significant cardiovascular and renal benefits, including reduced cardiovascular mortality and heart failure hospitalization, in addition to glycaemic control, by preventing glucose reabsorption in the kidneys.Strong
- Supervised combined exercise and dietary interventions significantly improve glycaemic control, comorbidities, and quality of life in Type 2 Diabetes Mellitus (T2DM) patients, with supervised exercise yielding superior outcomes to unsupervised regimens.Good
- GLP-1 receptor agonists (GLP1-RA), particularly long-acting formulations, provide superior glycaemic control, weight loss, and cardiovascular risk reduction compared to short-acting GLP1-RA, and are recommended for chronic weight management and MACE reduction.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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