Changing Incident Diabetes Regimens

Introduced in the mid-1950s, sulfonylureas have historically been the first line of treatment for type 2 diabetes (1). Metformin was introduced to the U.S. market in 1994 and has since experienced increasing market share (2). Metformin has many advantages over the sulfonylureas, including decreased weight gain and less risk of hypoglycemia (3). Despite some debate, the American Diabetes Association (ADA) recommended in 2006 that metformin be used as the first-line agent unless contraindicated (4). Whereas metformin use as a first-line agent was increasing before the ADA recommendations, no clear estimate of incident glycemic control regimens is available. A retrospective cohort of patients …