INS and diabetes mellitus: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) is an ongoing, pragmatic RCT to make head-to-head comparisons of GLP-1ra, DPP-4i, SU, and basal insulin in metformin-monotherapy patients with relatively recently-diagnosed T2D on glycemia-lowering effectiveness and patient-centered outcomes [38].