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Initial pharmacotherapy generally starts with metformin, which is an older, safe and relatively inexpensive drug. Frequently, other medications are required to control glucose levels, such as sodium-glucose cotransporter-2 (SGLT2) inhibitors or glucagon-like peptide 1 receptor agonists (GLP-1 RA). These medications can be particularly beneficial in people at an increased risk of or with established cardiovascular or kidney disease.[1] Up to 35% of people with T2D eventually require insulin to achieve their glycemic targets. Besides glucose-lowering medications, medications or procedures (i.e., metabolic surgery) that facilitate weight loss are also effective for improving glycemic control.
