What is the first-line treatment indicated for a patient newly diagnosed with type 2 diabetes?

Metformin is recognized as the first-line treatment for patients newly diagnosed with type 2 diabetes due to its proven efficacy in lowering blood glucose levels and its favorable safety profile. It works primarily by improving insulin sensitivity, reducing hepatic glucose production, and enhancing peripheral glucose uptake. Furthermore, metformin has additional benefits, such as weight neutrality or modest weight loss and a low risk of hypoglycemia when used as a monotherapy.

Other treatment options, while effective, are not typically used as the initial therapy for type 2 diabetes. For instance, insulin therapy, though effective in controlling blood sugar, is usually reserved for patients with more advanced diabetes or those who cannot achieve glycemic control with oral medications. Sitagliptin, a DPP-4 inhibitor, offers an alternative therapy but is not usually the first choice due to higher costs and less extensive evidence supporting its use as a first-line treatment. Glyburide, a sulfonylurea, can effectively lower blood glucose levels but carries a higher risk of hypoglycemia and weight gain compared to metformin, making it less favorable as an initial treatment option.

Thus, metformin's effectiveness, safety profile, and additional benefits make it the preferred first-line therapy in the management of newly