Diabetes is a progressive disease with lifelong (even in generations) effects. Medications may have their own side/adverse effects. Can prolonged use of indicated medications for type 2 diabetes also contribute to indicated diabetic or other complications? How can any medication program be considered as proper unless lifelong and in many generations double blinded studies are conducted with or without such medication program? Do we have some outcome from lifelong studies/observations of people with type 2 who were not on medication?
There is very good information about the risk of complications from diabetes, based on level of glucose control. Those agents that lower glucose also decrease complications. You could not do a placebo-controlled study anymore in humans where you did not treat them. It would not be ethical. Medications do have side effects. However, the risk of a medication has to be evaluated in terms of its risk-benefit analysis. Drugs such as the sulfonylureas, metformin, and insulin have been around a long time. They generally have a favorable risk-benefit relationship, when compared to long-term diabetes-related complications. Some other medications have not been used for as long, although they have been shown to lower glucose effectively in the short term.
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