Context

Current guidelines for type 2 diabetes recommend metformin as first-line therapy, but offer no conclusive guidance for choosing among at least six drug classes as add-on to metformin in patients in whom glycaemic targets are not met.1 In light of accumulating evidence for novel agents, it is imperative to update the comparative effectiveness and safety of available antidiabetic medications. Maruthur and colleagues have addressed this question through a recently published systematic review and meta-analysis, which assesses the effect of all commonly used glucose-lowering drug classes on long-term and intermediate outcomes.