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A recent network meta-analysis of 450 randomized clinical trials demonstrated various benefits of some newer pharmacologic diabetes agents (NEJM JW Gen Med Aug 1 2020 and Ann Intern Med 2020; 173:278). Based on these and other data, the ADA recently published new guidelines to inform management of type 2 diabetes.
The ADA provides a graphical representation of its recommendations online. First-line therapies include metformin and lifestyle modifications (i.e., weight management and physical activity). Early combination therapy can be considered at treatment initiation to extend the time to treatment failure (Grade A recommendation).
Patients with high…