Newly updated guidelines in US reaffirm metformin is first drug of choice for type 2 diabetes

by Barbara Hewitt on January 9, 2017

Metformin should be the first choice of doctors for patients with type 2 diabetes needing medication to control high blood sugar, according to new guidelines published in the United States.

The guideline from the American College of Physicians (ACP) says that several other medications, including newer ones, can be added if needed.

010917-pills-1160893‘Metformin, unless contraindicated, is an effective treatment strategy because it has better effectiveness, is associated with fewer adverse effects, and is cheaper than most other oral medications,’ said Nitin Damle, ACP president.

‘The escalating rates of obesity in the US are increasing the incidence and prevalence of diabetes substantially. Metformin has the added benefit of being associated with weight loss,’ he added.

He explained that ACP has updated its 2012 guideline on the comparative effectiveness and safety of oral medications for the treatment of type 2 diabetes because of several new studies evaluating medications for type 2 diabetes as well as recent FDA approvals of several new medications.

‘Adding a second medication to metformin may provide additional benefits. However, the increased cost may not always support the added benefit, particularly for the more expensive, newer medications. The ACP recommends that clinicians and patients discuss the benefits, adverse effects, and costs of additional medications,’ Damle added.

The ACP points out that diabetes is a leading cause of death in the US and the disease can cause retinopathy, nephropathy, neuropathy, and coronary artery, cerebrovascular, and peripheral vascular disease complications.

The guideline is based on a systematic review of randomised controlled trials and observational studies on the comparative effectiveness of oral medications for type 2 diabetes.

ACP’s clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies. The ACP also identifies gaps in evidence and direction for future research through its guidelines development process.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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