Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which class of medication is a common first-line treatment for type 2 diabetes?

1. SGLT-2 inhibitors

2. Biguanides

3. Thiazolidinediones

4. Insulin

The correct answer is: Biguanides

Biguanides, specifically metformin, are considered the first-line treatment for type 2 diabetes due to their efficacy in lowering blood glucose levels and their favorable safety profile. Metformin works primarily by decreasing hepatic glucose production, enhancing insulin sensitivity in peripheral tissues, and improving glucose uptake by muscle cells. This approach helps to lower blood sugar levels without causing significant weight gain or an increased risk of hypoglycemia, which are important considerations in managing type 2 diabetes. Additionally, metformin has other benefits, including potential cardiovascular advantages, making it a well-rounded choice for initial therapy. Its long history of use and established clinical outcomes support its status as the preferred starting medication in the treatment of type 2 diabetes. Other medication classes, while effective, have different positioning in treatment protocols. For example, SGLT-2 inhibitors and thiazolidinediones may be used after metformin or in specific circumstances but are not typically first-line treatments. Insulin is usually reserved for patients who require more intensive management or who have not achieved glycemic control with oral medications alone.