# #192 Debate on First-Line Medications for Diabetes

An episode of [Core IM | Internal Medicine Podcast](https://invisiblenetwork.ai/podcast/1297791208), 5 Nov 2025, 37 min.

Audio: https://pscrb.fm/rss/p/audio2.redcircle.com/episodes/42506592-ce24-4712-af4a-b32c878ee9d6/stream.mp3

SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use? 🔹 Sponsor: Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show Notes Timestamps: (01:43) | Case 1: Managing Uncontrolled Diabetes in a 47-Year-Old Male (07:15) | Understanding Cost and Insurance Barriers in Diabetes Care (09:26) | Case 2: Addressing Weight Gain and Financial Stress in a 52-Year-Old Male (14:16) | Case 3: Managing Coronary Artery Disease and CKD in a 66-Year-Old Male (19:41) | Case 4: Severe Obesity and Pain Management in a 59-Year-Old Female (24:19) | Case 5: High A1C and Vascular Comorbidities in a 67-Year-Old Female (35:34) | Weighing Side Effects and Practical Use of GLP-1 and SGLT2 Inhibitors Tags: CoreIM, Primary Care, Endocrinology, Diabetes Mellitus, Type 2 Diabetes, Type 1 Diabetes, Metformin, GLP-1, SGLT2, Insulin, CGM, A1C, DKA, Medical Education, Clinical Reasoning, Hospital Medicine Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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