More than 90% of persons with type 2 diabetes will require more than metformin monotherapy to meet their glucose targets. The sodium–glucose cotransporter 2 (SGLT2) and dipeptidyl peptidase-4 (DPP-4) inhibitor classes are among the several second-line treatments for type 2 diabetes glucose management. In comparison to prior classes, these newer classes provide a number of advantages, including a lower risk of hypoglycemia and weight gain, as well as no requirement for dose titration. An SGLT2 inhibitor can cause rapid, considerable, and long-term weight reduction (about 2–3 kg in 6 months) by causing glucose and consequently calorie loss in the urine as compared with DPP4 inhibitors which are weight neutral. Also SGLT-2Is have shown better reno and cardio protective effects as compared with DPP4 inhibitors but contraindicated in setting of CKD as against DPP4 inhibitors.

Conclusion:  To conclude SGLT2 inhibitor may be beneficial in a younger person with suboptimal blood glucose management early in their illness course, weight loss is a focus, and bladder dysfunction and comorbidities are not limiting factors while in an older person for whom weight loss is not a priority and bladder dysfuncjh6tion and comorbidity are commonly limiting factors, a DPP-4 inhibitor with good tolerance and efficacy could be beneficial. Now’-days since combination pills are also available, they can be used for their complementary beneficial effects.