Guidelines recommend metformin monotherapy as first-line treatment, with the rapid (after 3 months) addition of a second or third antidiabetes agent and/or insulin if glycemic goals are not met.13 A large retrospective study showed that ∼85% of patients with T2D in primary care are prescribed metformin and almost 25% receive insulin.14 Thus, the patients included in this study, on background metformin or insulin (plus up to two OADs), represent the diverse population of patients with T2D commonly encountered in clinical practice. Here, INS is linked to type 2 diabetes mellitus.