EVOLVING TREATMENTS IN TYPE 2 DIABETES: A FOCUS ON METFORMIN, TIRZEPATIDE, AND SEMAGLUTIDE

Type 2 diabetes (T2D) remains a major global health challenge, driven by insulin resistance, β-cell dysfunction, and associated comorbidities such as cardiovascular disease and chronic kidney disease. Metformin remains the cornerstone treatment because of its cardiovascular advantages, safety, and effectiveness, despite its limits in advanced disease and renal impairment. Recent developments in medicine have brought incretin-based medications, such as semaglutide, a long-acting GLP-1 receptor agonist, and tirzepatide, a dual GIP/GLP-1 receptor agonist. In comparison to selective GLP-1 agonists, tirzepatide exhibits better glycemic control, weight loss, and β-cell preservation; nonetheless, there are issues with gastrointestinal tolerability. Semaglutide, which comes in injectable and oral forms, has demonstrated improvements in heart failure with retained ejection fraction and obesity, as wellas a notable decrease in cardiovascular risk. The backbone and incretin-based drugs as supplements, providing complementary enhancements in weight control, glycemic control, and long-term results. In order to maximize patient-centered care, this study emphasizes the integration of metformin, tirzepatide, and semaglutide into clinical practice, highlighting changing treatment paradigms in type 2 diabetes.