Inclusion Criteria:  Diagnosis of Type 2 Diabetes mellitus [0,0] days 3 or more recorded HbA1c values [-365, 0] days At least two dispensing claims for metformin [-180,0] days 1 or more recorded HbA1c values [-90,0] days Age between 18-80 [0,0] days  Exclusion Criteria:  Cancer, malignant neoplasm, or MEN2 [-1,825,0] days Use of other anti-diabetic medications [-180,0] days Cirrhosis or Hepatic decompensation [-180,0] days Viral hepatitis B or C [-180,0] days Stage 5 CKD, ESRD, dialysis or renal transplant [-180,0] days MI or HF [-180,0] days Treatment with Anti-VEGFi or Photocoagulation [-180,0] days Hypertensive crisis or uncontrolled hypertension [-180,0] days Two diagnoses of hypoglycemia [-180,0] days Alcohol/drug abuse/dependence [-180,0] days Dementia and brain damages or non-compliance [-180,0] days Pregnancy [-180,0] days Type 1 DM, DKA, or other metabolic acidosis [-180,0] days Systemic corticosteroids [-90,0] days