Current estimates indicate that type 2 diabetes (T2DM) now affects more than 500 million people worldwide. Improving glycaemic control in people with T2DM is critical to improving quality of life and preventing or delaying progression to micro- and macrovascular complications. For people living with diabetes, cardiovascular risk is estimated to be 2–5 times higher than those without diabetes. Microvascular complications such as retinopathy, nephropathy, and neuropathy are also common among people with T2DM, especially those with a disease duration of >10 years.

The recent expansion of treatments for T2DM should pave the way for improved glycaemic control and an associated reduction in diabetes-related complications. Most guidelines for the treatment of T2DM recommend metformin as the first-line drug, with a second medication added if needed to achieve or maintain individualized glycaemic targets. However, choosing the most appropriate second-line drug is complicated by a lack of long-term comparator studies.



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