Horii T, et al. - In treatment naïve patients with type 2 diabetes in Japan, researchers sought to compare treatment intensification and clinical outcomes of metformin and dipeptidyl peptidase-4 inhibitors (DPP-4Is). They studied the frequency of occurrence to treatment intensification following the initiation of metformin or DPP-4I treatment. Findings suggested an association of initiation of DPP-4I with a low hazard of intensification in multivariable-adjusted Cox proportional hazard models. According to results, DPP-4Is were Japan's preferred first-line treatment due to the high treatment continuation rate and lowering effect of Hemoglobin A1c. This information would provide guidance for the selection of initial hypoglycemic drugs in Japan and Asia to optimize the treatment of type 2 diabetes mellitus.