A Comparison of Two Treatment Strategies in Older Participants With Type 2 Diabetes Mellitus (T2DM)

Inclusion Criteria:

- Have T2DM based on a history and clinical impression that is consistent with the
World Health Organization [WHO] Classification of Diabetes

- Have a Clinical Frailty Scale (CFS) score of 4 or above or Total Illness Burden Index
(TIBI) score of 5 or above as assessed at screening

- Have an A1c >7.3% and <10.9% at study entry and are not achieving desired glycemic
control as evidenced by A1c measurement at least 0.4% higher than individualized
treatment target set at screening.

- Have been treated for at least 3 months prior to the study entry with any of the
following treatment options:

- Diet/exercise only (only if they have known contraindications to metformin
treatment)

- Any dose of sulfonylurea

- Effective or maximally-tolerated doses of metformin, dipeptidyl-peptidase-4
(DPP-4) inhibitor, thiazolidinedione, or acarbose used in monotherapy or in dual
combination. The following doses are considered to be effective:

- at least 1500 mg of metformin per day

- At least 30 mg of pioglitazone per day

- At least 4 mg of rosiglitazone per day

- At least 75 mg of acarbose per day

- Any marketed dose of DPP-4 inhibitor

Exclusion Criteria:

- Are currently enrolled in a clinical trial involving an investigational product or
nonapproved use of a drug or device (other than the investigational product used in
this study), or concurrently enrolled in any other type of medical research judged
not to be scientifically or medically compatible with this study

- Have participated, within the last 60 days in a clinical trial involving an
investigational product other than the investigational product used in this study. If
the previous investigational product has a long half-life, 3 months or 5 half-lives
(whichever is longer) should have passed

- Have previously completed or withdrawn from this study. This exclusion criterion does
not apply to participants who are rescreened prior to randomization

- At study entry, have contraindications to sulfonylurea, insulin, or GLP-1 RA

- Have a history of pancreatitis, a personal or family history of medullary thyroid
carcinoma, or have Multiple Endocrine Neoplasia syndrome type 2

- Have taken any injectable glucose-lowering agent, miglitol, meglitinide,
Sodium/Glucose cotransporter-2 inhibitor, or other antihyperglycemia treatment that
is not listed in the fourth inclusion criterion for more than 10 days within 3 months
prior to the study entry

- In the opinion of investigator should have an individualized A1c target set at 8% or
higher

- Have a body mass index (BMI) greater than 45 kg/m^2

- Have had more than 1 episode of severe hypoglycemia within 24 weeks prior to the
study

- Have cardiac disease with functional status that is Class III or IV according to the
New York Heart Association Cardiac Disease Classification

- Have an estimated glomerular filtration rate (eGFR) <30 milliliter/minute/1.73 m^2
(mL/min/1.73 m^2) or advance renal disease including history of renal transplantation
or currently receiving renal dialysis

- Have obvious clinical signs or symptoms or laboratory evidence of liver disease
(alanine aminotransferase [ALT] or aspartate aminotransferase [AST] > 2.5 times the
upper limit of the reference range)

- Receive current therapy for a malignancy, other than basal-cell or squamous-cell skin
cancer

- Received systemic glucocorticoids within the 3 months prior to entry for more than 14
consecutive days

- Have any other condition that precludes the participant from following and completing
the study