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The American Diabetes Associations position that metformin should remain the first-line treatment for most type 2 diabetes cases is partly driven by this cost advantage at roughly $120 per year versus over $11,000 annually for Rybelsus, metformins modest efficacy is justified for 90% of people starting type 2 diabetes treatment

Wong C, Lee MH, Yaow CYL, Chin YH, Goh XL, Ng CH, et al

Additionally, vomiting and diarrhea can deplete essential electrolytes including sodium, potassium, magnesium, and calciumall of which play critical roles in normal muscle contraction and relaxation

Avoid accepting proprietary mixes without clear ingredient lists