The main goals of treatment are to eliminate hyperglycemic symptoms, control the long term complications and improve the patient's quality of life.<unk>  mellitus type<unk>   is initially treated by life style modification and weight loss, especially in obese patients. Metformin is the first line pharmacologic therapy that is usually started once the diagnosis is confirmed unless contraindications exist. Nevertheless, in patients presented with high HbA1C/fasting blood sugar levels or if glycemic goals are not achieved, a second agent must be added to metformin.  A wide range of options are available to add as combination therapy based on the patient's condition and comorbidities.
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