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Here are the key recommendations: 1 Type 2 Diabetes with No Relevant Comorbidities First-line therapy: Modified-release Metformin + SGLT2 inhibitor If Metformin is contraindicated or not tolerated: SGLT2 inhibitor monotherapy 2 Type 2 Diabetes with Heart Failure Initial therapy: Modified-release Metformin + SGLT2 inhibitor If Metformin cannot be used: SGLT2 inhibitor alone 3 Type 2 Diabetes with Atherosclerotic Cardiovascular Disease (ASCVD) Recommended combination therapy: Metformin SGLT2 inhibitor Semaglutide (up to 1 mg weekly) If Metformin is contraindicated: SGLT2 inhibitor + Semaglutide 4 Early-Onset Type 2 Diabetes Initial treatment: Modified-release Metformin + SGLT2 inhibitor Consider adding: GLP-1 receptor agonist or Tirzepatide for improved glycemic and cardiometabolic outcomes 5 Type 2 Diabetes with Obesity Recommended first-line therapy: Modified-release Metformin + SGLT2 inhibitor Additional weight-focused therapies may be considered based on individual patient needs

When to Seek Immediate Emergency Care: If you or a loved one experiences severe confusion, extreme lethargy, fainting spells (syncope), an complete inability to urinate for over 12 to 18 hours, or severe, sharp abdominal pain, seek immediate emergency medical attention