Metformin in diabetes

This may be an area where doctors disagree. The Malaysian Clinical Practice Guidelines on managing type 2 diabetes (2009) tell us that one can wait up to three months before starting Metformin in a newly diagnosed diabetic unless the plasma glucose or HbA1c is "very high". But how high is "very high" is not specified. The American Association of Clinical Endocrinologists, in their 2007 guidelines on managing diabetes inform us that we can:

…Aggressively implement all appropriate components of care (medical nutrition therapy, physical activity, weight management regimen, pharmacologic interventions, diabetes self-management education) at the time of diagnosis.


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