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Options for second-line therapy include DPP-4 inhibitors, SGLT2 inhibitors, sulphonylureas, or GLP-1 receptor agonists, depending on individual circumstances

doi: 10.1161/CIRCRESAHA.120.316101 33 YuanJWangMPanYLiangMFuYDuanYet al

So they are much less likely to be covered by insurers in commercial plans and were covered by only a few state Medicaid programs
This transition requires careful medical supervision, as stopping insulin while starting a GLP-1 drug involves monitoring for hyperglycemia during the switch period
