What is the preferred first-line non-insulin agent in patients with ketosis-prone diabetes during "remission" and evidence of preserved beta cell function?

Ketosis-prone diabetes (KPD) is an atypical form of diabetes that has been found in various racial and ethnic groups (Asian Indian, South American, West African, African American and others). People with KPD may present with DKA without the autoimmune findings of Type 1 diabetes. After the DKA episo...

In these patients, we should return to the old-school recommendations (before SGLT2-i and GLP-1 RA were available) and recommend metformin.

SGLT2-i would be contraindicated (or used with significant caution) due to their risk of further DKA. GLP-1 RA could be used, but if they recently had DKA (whic...