Question

Which oral drug is the first-line treatment in most newly diagnosed type 2 diabetes patients who are overweight?

• A. Metformin
• B. Acarbose
• C. Glibenclamide
• D. Sitagliptin

Hint:

Metformin is the first-line oral antidiabetic drug in most type 2 diabetes patients, especially if overweight.

Answer 1

The Correct Option is A

Concept:
Type 2 diabetes mellitus is commonly associated with insulin resistance. In overweight patients, insulin resistance is a major problem.

Step 1: Understanding the requirement.
The question asks for the first-line oral drug in newly diagnosed type 2 diabetes patients who are overweight.

Step 2: Role of metformin.
Metformin is a biguanide antidiabetic drug. It mainly reduces hepatic glucose production and improves insulin sensitivity. \[ \text{Metformin} \Rightarrow \text{decreased hepatic gluconeogenesis} \]

Step 3: Why metformin is preferred in overweight patients.
Metformin does not usually cause weight gain. It may also help in modest weight reduction or weight neutrality, so it is preferred in overweight type 2 diabetic patients.

Step 4: Checking other options.
Acarbose delays carbohydrate absorption but is not the usual first-line drug.
Glibenclamide is a sulfonylurea and may cause hypoglycemia and weight gain.
Sitagliptin is a DPP-4 inhibitor but is not usually the first-line choice over metformin.

Step 5: Final answer.
Therefore, the first-line drug is metformin. \[ \boxed{\text{Metformin}} \]