Inclusion Criteria:  Age ≥ 18 years for Optum Cliniformatics, IBM Marketscan, CPRD, and VHA, and ≥ 65 years for Medicare FFS at cohort entry At least 12 months of continuous health plan enrollment (only claims) or registration with a general practitioner (CPRD) before and including cohort entry Diagnosis of T2D within 12 months before (or ever before in CPRD) and including cohort entry Low or moderate cardiovascular (CV) risk (≤3% risk of CV events/year) at cohort entry * Metformin maintenance therapy, defined as 2 fills (or prescriptions in CPRD) of metformin monotherapy recorded within 6 months before and including cohort entry  Exclusion Criteria:  Missing age or gender information Nursing care admission within 12 months before and including cohort entry (criteria ignored in CPRD) Diagnosis of type 1 diabetes within 12 months before and including cohort entry Diagnosis of secondary or gestational diabetes within 12 months before and including cohort entry Any insulin fill or prescription within 12 months before and including cohort entry Diagnosis of end stage renal disease (stage ≥ 5) within 12 months before and including cohort entry Diagnosis of acute or chronic pancreatitis within 12 months before and including cohort entry Diagnosis of cirrhosis or acute hepatitis within 12 months before and including cohort entry Diagnosis of MEN-2 within 12 months before and including cohort entry Recorded solid organ transplant code within 12 months before and including cohort entry Patients with recorded initiation of more than one agent within a comparator class at cohort entry