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Clinical Scenarios: When to Use or DePrioritize Metformin Scenario 1: Newly Diagnosed, Low Cardiovascular Risk A 48-year-old patient with newly diagnosed type 2 diabetes, an A1C of 7.3%, and no cardiovascular risk factors may still benefit from starting metformin
GLP-1 agonists are one of a few classes of diabetes medications proven to have cardiovascular, renal and mortality benefit in large-scale prospective randomised controlled trials
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Do not discontinue Ozempic without medical advice
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Their high monthly price also places pressure on payers, who may impose restrictions, prior authorizations, or step-therapy requirements that reduce access
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