Pharmacy PEBC Practice Exam

The first-line treatment for type 2 diabetes mellitus is metformin due to its well-established efficacy, safety profile, and metabolic benefits. Metformin works primarily by decreasing hepatic glucose production and improving insulin sensitivity, which helps to lower blood glucose levels.

Additionally, metformin has been shown to provide cardiovascular benefits and is associated with weight neutrality or modest weight loss, making it a preferred option for many patients with type 2 diabetes, especially those who are overweight.

The other options, while they have roles in managing type 2 diabetes, are generally considered second-line treatments or are used in specific situations. Insulin is often reserved for cases where blood glucose levels are not adequately controlled with oral medications. Sulfonylureas and GLP-1 receptor agonists, though effective, are typically used when metformin alone is insufficient in achieving glycemic control. Therefore, metformin is the cornerstone of pharmacotherapy for type 2 diabetes, making it the recommended first-line treatment.