With a plethora of new drugs for diabetes, and distinct differences in their mechanisms of action and non-glycaemic effects, the selection of a second-line medication to add to metformin is now a complex decision. Guidelines^1,2 offer some suggestions for individualisation of treatment, based on efficacy, side-effects, and cost. But the appropriate choice might be challenging for clinicians, patients, and payers, and older (and cheaper) drugs such as sulfonylureas and thiazolidinediones remain in use despite concerns about side-effects.

中文翻译：

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吡格列酮与磺脲类药物：老年糖尿病药物的心血管预后

由于存在大量用于糖尿病的新药，并且它们的作用机理和非血糖作用存在明显差异，因此选择添加到二甲双胍中的二线药物现已成为一个复杂的决定。指南^1,2根据疗效，副作用和费用，为个性化治疗提供了一些建议。但是，对于临床医生，患者和付款人而言，适当的选择可能会面临挑战，尽管担心副作用，但磺酰脲类和噻唑烷二酮类等较旧（且更便宜）的药物仍在使用。