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The American Diabetes Associations position that metformin should remain the first-line treatment for most type 2 diabetes cases is partly driven by this cost advantage at roughly $120 per year versus over $11,000 annually for Rybelsus, metformins modest efficacy is justified for 90% of people starting type 2 diabetes treatment

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Large-scale clinical trials and real-world data have documented higher rates of gallbladder events in patients taking these medications compared to control groups

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Patients should seek medical guidance promptly for severe abdominal pain, persistent vomiting, signs of dehydration, symptoms of gallbladder problems, allergic reaction symptoms, or any concerning change after starting medication