Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

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What is the recommended initial drug therapy for people with type 2 diabetes by the American Diabetes Association?

Acarbose
Sulfonylureas
Metformin
SGLT-2 inhibitors

The correct answer is: Metformin

The American Diabetes Association (ADA) recommends metformin as the initial drug therapy for people with type 2 diabetes due to its favorable side effect profile and proven efficacy in lowering blood glucose levels. Metformin primarily works by decreasing hepatic glucose production and improving insulin sensitivity, making it an effective treatment option for most individuals diagnosed with type 2 diabetes. Additionally, metformin is associated with weight stability or modest weight loss, which is often beneficial for individuals with type 2 diabetes who are typically overweight or obese. It also has cardiovascular benefits, being linked to a lower risk of complications related to heart disease, which is a common concern for those with diabetes. While other medications, such as sulfonylureas, SGLT-2 inhibitors, and acarbose, are effective in managing blood glucose levels, they are typically considered for use after metformin or in specific clinical circumstances. Therefore, the recommendation for metformin aligns with current clinical guidelines aimed at optimizing treatment outcomes for people with type 2 diabetes.