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When starting initial medication in people with type 2 diabetes mellitus (T2DM), the appropriate drug should be selected considering characteristics of the patient, efficacy, side effects, and cost. It is generally recommended to use metformin as the first-line treatment oral hypoglycemic agent in T2DM patients. Metformin is recommended as the first treatment because of its excellent glucose lowering effect, relatively mild side effects, long-term safety, low risk of hypoglycemia, and small weight gain. If it is difficult to use metformin as a first-line treatment, appropriate drugs can be selected based on the clinical situation.

Monotherapy in Type 2 Diabetes Mellitus Patients 2017: A Position Statement of the Korean Diabetes Association