ɪɾ ɪz jˈuːzd wɛn dˌaɪəbˈiːɾiːz kænˈɑːt biː kəntɹˈoʊld baɪ pɹˈɑːpɚ dˈaɪətɚɹi mˈænɪdʒmənt ænd ˈɛksɚsˌaɪz ænd wɛn mˈɛtfoːɹmˌɪn hɐz ɔːlɹˌɛdi bˌɪn tɹˈaɪd.
It is used when diabetes cannot be controlled by proper dietary management and exercise and when metformin has already been tried.