Which statement about metformin is correct?

Which statement about metformin is correct?

• A. First-line medication for managing diabetes in adults.
• B. Second-line after lifestyle changes fail.
• C. Not used in adults.
• D. Only for type 1 diabetes.

Answer: (A)

Metformin as the first-line pharmacologic therapy for adults with type 2 diabetes is supported because it effectively lowers blood glucose by reducing hepatic glucose production and improving insulin sensitivity, while having a low risk of causing hypoglycemia when used alone. Its tolerability, potential for weight neutrality or modest weight loss, and evidence of cardiovascular benefit make it the preferred initial medication alongside lifestyle changes. It is not appropriate for type 1 diabetes, where insulin is required, and it isn’t a later step after lifestyle changes have failed; guidelines typically recommend starting metformin early unless there are contraindications. In older adults, renal function is an important consideration because reduced kidney function can affect metformin use, so dosing or avoidance is guided by kidney function.

Metformin as the first-line pharmacologic therapy for adults with type 2 diabetes is supported because it effectively lowers blood glucose by reducing hepatic glucose production and improving insulin sensitivity, while having a low risk of causing hypoglycemia when used alone. Its tolerability, potential for weight neutrality or modest weight loss, and evidence of cardiovascular benefit make it the preferred initial medication alongside lifestyle changes. It is not appropriate for type 1 diabetes, where insulin is required, and it isn’t a later step after lifestyle changes have failed; guidelines typically recommend starting metformin early unless there are contraindications. In older adults, renal function is an important consideration because reduced kidney function can affect metformin use, so dosing or avoidance is guided by kidney function.