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The unfortunate truth is that big risk signals (lets say the kind you get from drinking antifreeze) can be spotted from the anecdotal experience of people in the world just trying things, but small-but-serious risk signals (lets say cardiovascular disease with tofacitinib) are really hard to identify without a proper trial or a proper observational study

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* Medication from a retail pharmacy (e.g., CVS and Walgreens) will have an out-of-pocket expense or insurance deductible or copay paid by the patient

Nauck, MA, et al

Most patients (97%) were treated with one or more glucose lowering medications at baseline: metformin (76%), insulin (51%), SGLT-2 inhibitor (27%), sulfonylurea (29%), and DPP-4 inhibitor (23%)