Emedinews : Metformin reduces A1C levels more than DPP-IV inhibitor monotherapy

Metformin as initial therapy is supported by a meta-analysis of 140 trials and 26 observational studies.

Older drugs (metformin and second generation sulfonylureas) had similar efficacy in reducing A1C values (1%) and other cardiovascular risk factors (blood pressure, lipids, body weight) compared with newer drugs (thiazolidinediones, meglitinides, and GLP-1 receptor agonists).

Source: Ann Intern Med 2011; 154:602.

Emedinews: Dr Good Dr Bad: An elderly obese diabetic was put on metformin therapy.

Situation: An elderly obese diabetic was put on metformin therapy.
Dr. Good: It cannot be prescribed to the elderly.
Dr. Bad Continue it.
Lesson: For elderly patients who do not have contraindication to metformin (severe renal impairment or heart failure), one should initiate therapy with metformin.
 (American Geriatric Society, American Diabetes Association, European Diabetes working Party and Guidelines)