Inclusion Criteria:  Age greater or equal than 30: days [0,0] Diagnosis of Type 2 Diabetes: days [- All Data, 0] 2+ recorded HbA1c levels: days [-365,0] Metformin use: days [-30, 0]  Exclusion Criteria:  Type 1 or Secondary DM: days [-All Data, 0] Previous organ transplant: days [-All Data, 0] HIV/AIDS: days [-All Data, 0] History of bariatric surgery: days [-All Data, 0] Congestive heart failure: days [-All Data, 0] NYHA >=3: days [-All Data, 0] Pancreatitis: days [-All Data, 0] Medullary thyroid cancer/MEN-2: days [-All Data, 0] History of MI: days [-365, 0] Stroke: days [-365, 0] Coronary Revascularization: days [-365, 0] PTCA/Stenting/CABG: days [-365, 0] Trans myocardial revascularization: days [-365, 0] Carotid bypass: days [-365, 0] Cerebrovascular revascularization: days [-365, 0] PVD: days [-365, 0] CCI >=10: days [-365, 0] History of cancer, other than non-melanoma skin cancer: days [-1,825, 0] Treatment of metformin more than 10 years: days [-3,650, 0] Treatment with any diabetes drug other than metformin; PCOS; symptomatic hyperglycemia; pregnancy; gestational diabetes: days [-180, 0] History of hemolytic anemia; history of severe liver disease; current alcoholism; chronic transfusion requirement; ESRD: days [-180, 0] Oral, IV, or IM cortisone, hydrocortisone, prednisone, methylprednisone, or dexamethasone: days [-90, 0] Treatment with atypical antipsychotics, language barriers, nursing home, or missing age or gender: days {-180, 0] Hospitalization with length of stay >3 days: days [-30, 0]