There has been an increasing trend in the prevalence of type 2 diabetes worldwide secondary to the adaptation of the western lifestyle and increase in obesity rates. Tight glycemic control has been shown to reduce microvascular and macrovascular complications; therefore, it is important that patients are individualized with regards to their therapy, taking into account factors such as age, comorbidities, duration of disease, and risk of hypoglycemia. Upon initial diagnosis, patients should attempt to achieve glycemic control by introducing lifestyle changes that include, but are not limited to, diet modification, weight control, smoking cessation, alcohol abstinence, and increased physical activity, all of which must be reinforced via diabetes education. If the patient is unable to achieve their glycemic target after lifestyle interventions, pharmacotherapy is installed. Metformin is the initial drug of choice used as monotherapy, but other classes of antihyperglycemic agents can be added if glycemic target is not met with Metformin monotherapy. The American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) recommend the addition of either of the following: sulfonylurea, thiazolidinedione, DPP-4 inhibitor, SGLT2 inhibitors, GLP-1 receptor agonist, or basal insulin. The drug of choice is based on the state of the patient as well as their preference, giving consideration to any drug-drug interactions, side effects, and mechanism of action.

Keywords: ADA, EASD, Glycemic control, Lifestyle management, Type 2 Diabetes