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The primary outcome was the time to primary failure defined as an A1c 7% over an anticipated mean observation period of 5 years The results as expected demonstrated that the GLP-1 receptor agonist liraglutide was more effective than the sulfonylurea glimepiride and the DPP4 inhibitor sitagliptin in maintaining the A1c 180 mg/dl (i.e., secondary failure) (31)

However, the Cochrane review conducted by Showell et al

[PubMed: 29098788] 145

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No insurance is required, and the medication is HSA/FSA eligible, making long-term therapy financially sustainable