This observational cohort study sought to determine the effect of initial oral glucose-lowering class on subsequent need for additional anti-hyperglycemia therapy. Participants included 15,516 patients who were not previously treated for diabetes, in whom therapy with metformin, a sulfonylurea (SU), a thiazolidinedione (TZD), or a dipeptidyl peptidase 4-inihibitor (DPP4) was initiated. The primary outcome was time to treatment intensification, defined as initiation of a different class of oral glucose-lowering medication…..more