Family Nurse Practitioner Exam

What is the first-line treatment for new-onset type 2 diabetes?

1. Metformin

2. Insulin therapy

3. Sulfonylureas

4. DPP-4 inhibitors

The correct answer is: Metformin

Metformin is the first-line treatment for new-onset type 2 diabetes primarily because of its effectiveness in lowering blood glucose levels and its favorable side effect profile. As an oral antihyperglycemic agent, metformin primarily works by decreasing hepatic glucose production and increasing insulin sensitivity in peripheral tissues, enhancing the body’s response to insulin. Moreover, numerous clinical guidelines recommend metformin as the initial therapy for managing type 2 diabetes due to its benefits beyond just glucose control; it may also promote modest weight loss and has a low risk of hypoglycemia compared to other medications. Unlike insulin therapy, which is often reserved for more advanced cases of diabetes or situations where immediate control is required, metformin can be initiated early in the course of the disease. Additionally, while other medications such as sulfonylureas and DPP-4 inhibitors have a role in diabetes management, they are generally recommended as add-on therapies after metformin when blood glucose targets are not met. This established position makes metformin the cornerstone of type 2 diabetes treatment and a critical component of the management protocol.