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Once the decision to initiate pharmacotherapy is made, metformin is recommended as the initial antihyperglycemic medication because of its durable efficacy in lowering A1C, negligible risk for hypoglycemia or weight gain [12] [Grade A, Level 1A], relatively mild side-effect profile, long-term track record, and affordability

This aligns with natural circadian rhythms and provides a standardised baseline

This is physiological, not psychological

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Highlights : One of the first GLP-1 drugs, effective for blood glucose control but less commonly used today due to newer options with greater weight-loss benefits