In this research study, we are trying to understand how blood sugar control develops and changes in adults with recently diagnosed type 2 diabetes. We aim to better understand how the body’s insulin and glucose regulation systems respond to different combinations of FDA-approved diabetes medications. Poor blood sugar control is related to complications in the kidneys, eyes, and nerves, and we will measure all of these outcomes.

We also want to see which medication combinations are most effective at improving blood sugar control and maintaining healthy glucose levels over time. To do this, we are using detailed metabolic testing — including glucose tolerance tests, insulin sensitivity and secretion assessments, body composition scans, and eye exams — to guide treatment plans and understand their effects on overall metabolic health.

You may be eligible for this study if you meet the following criteria.

Inclusion Criteria:

• Diagnosed with type 2 diabetes within the past 5 years
• HbA1c greater than 6.4%

Exclusion Criteria:

• Currently taking Ozempic, Mounjaro, or insulin
• Pregnant or breastfeeding
• Unable to attend some visits that are 6-8 hours long
• Any condition that, in the opinion of the study team, would make participation unsafe

The entire study lasts 6–12 months, with additional follow-ups up to 5 years. Once enrolled, the study involves:

In the clinic: 3–4 visits initially for comprehensive metabolic testing, including glucose tolerance testing, insulin sensitivity and secretion assessments, body composition scans (DEXA), eye exams, carotid ultrasound, liver fibroscan, and MRI. Each visit may also include blood draws. After baseline testing, participants begin study medications and return every 2–4 weeks initially, then monthly for monitoring and additional assessments.

At home: Participants may be asked to track daily habits such as diet, physical activity, or medication adherence using an app or log. This helps researchers understand how lifestyle and medication use affect blood sugar control over time.

As a participant, you will receive monetary compensation for your time and travel.

There is no cost for you to participate in our research study.