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For patients with type 2 diabetes, the American Diabetes Association (ADA) Standards of Care emphasize individualized glycemic targets and treatment selection based on patient-specific factors including baseline hemoglobin A1c (HbA1c), presence of atherosclerotic cardiovascular disease (ASCVD), heart failure, or chronic kidney disease, hypoglycemia risk, weight considerations, and patient preferences

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Long-term follow-up in the DPPOS showed that adherent metformin users maintained roughly 6.2% weight loss below baseline after 15 years, demonstrating durable but modest results particularly in individuals with insulin resistance and higher BMI