Which oral medication is considered first-line for treating type 2 diabetes after lifestyle changes?

Metformin is considered the first-line medication for treating type 2 diabetes after lifestyle changes because it has a well-established efficacy profile in lowering blood glucose levels and improving insulin sensitivity. Metformin works primarily by decreasing hepatic glucose production and enhancing peripheral glucose uptake, which leads to better glycemic control without an associated risk of weight gain, making it a preferable choice for many patients. Furthermore, it has been shown to have beneficial effects on cardiovascular health and is associated with a lower risk of hypoglycemia compared to other diabetes medications.

In addition, the choice of medication aligns with guidelines from various diabetes organizations that advocate for metformin as the initial pharmacotherapy. While other medications like sulfonylureas may also be used to lower blood glucose effectively, they carry a higher risk of hypoglycemia and potential weight gain, making them generally less preferable as a first-line option right after lifestyle interventions.