Type 2 diabetes mellitus is a chronic metabolic disorder characterized by insulin resistance and inadequate insulin secretion, resulting in elevated blood glucose levels¹. Unlike type 1 diabetes, which involves the immune-mediated destruction of insulin-producing beta cells, type 2 diabetes often develops in adulthood and is strongly associated with lifestyle factors such as poor diet, sedentary behavior, and obesity^2-3. This condition accounts for the majority of diabetes cases worldwide. Over time, uncontrolled type 2 diabetes can lead to complications affecting the heart, blood vessels, eyes, kidneys, and nerves. Lifestyle modifications, including a balanced diet, regular physical activity, and weight management, are crucial components of its management, along with medications and, in some cases, insulin therapy. The rising global prevalence of type 2 diabetes underscores the importance of public health initiatives focused on prevention, early detection, and comprehensive care to mitigate the impact of this prevalent and potentially debilitating chronic condition^4-5.
DPP-4 inhibitors and SGLT-2 inhibitors are two distinct classes of antidiabetic medications commonly employed in the treatment of Type 2 diabetes mellitus. DPP-4 inhibitors, such as Sitagliptin, work by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4), which in turn increases the concentration of incretins, such as GLP-1 (glucagon-like peptide-1), leading to enhanced insulin secretion and reduced glucagon levels^6-7. This mechanism helps regulate blood glucose levels by promoting insulin release in response to elevated blood sugar and suppressing glucagon, thereby lowering overall blood glucose. On the other hand, SGLT-2 inhibitors, such as Dapagliflozin, function by blocking the sodium-glucose co-transporter 2 (SGLT-2) in the renal tubules, preventing the reabsorption of glucose and promoting its excretion through urine. By enhancing the elimination of excess glucose, SGLT-2 inhibitors contribute to lowering blood glucose levels independently of insulin action. Both classes of medications offer valuable options in the management of Type 2 diabetes, with their distinctive mechanisms addressing different aspects of glucose metabolism, providing flexibility in treatment strategies^8-9. Understanding their individual efficacies becomes imperative to tailor treatment strategies effectively. DPP-4 inhibitors enhance insulin secretion and reduce glucagon levels, while SGLT-2 inhibitors facilitate glucose excretion, both addressing different facets of glucose regulation¹⁰. As patients with Type 2 diabetes often exhibit heterogeneous responses to medications, evaluating the comparative efficacy of DPP-4 inhibitors versus SGLT-2 inhibitors becomes pivotal. Such studies aim to refine treatment approaches, optimizing glycemic control, minimizing complications, and ultimately enhancing the quality of life for individuals grappling with this prevalent and potentially debilitating condition.