What are the first-line treatment options for type 2 diabetes?

Metformin is the first-line pharmacotherapy for type 2 diabetes in most clinical guidelines combined with lifestyle modification as a co-intervention. According to the 2024 ADA Standards of Care patients with established cardiovascular disease heart failure or chronic kidney disease should receive a GLP-1 receptor agonist or SGLT2 inhibitor with proven cardiorenal benefit independently of metformin use.