When metformin doesn't keep type 2 diabetes in check, a second medication can help. This article takes you through the latest options for combination therapy, focusing on evidence-backed choices, side effects, and practical decision-making tips for clinicians. We break down the pros and cons of each class, from SGLT2 inhibitors to GLP-1 agonists, and discuss how to individualize your strategy based on the patient's profile. You'll even find a direct resource for spotting new and alternative medications to metformin. Make your next prescribing decision with clarity and confidence.