[Recommendations of the main clinical practice guidelines]

The development of new drugs to treat hyperglycemia in persons with type 2 diabetes mellitus and recent cardiovascular safety studies of these new molecules have created the need to update the various clinical practice guidelines and consensus documents on the approach and treatment of this highly prevalent disease. Metformin continues to be the first-line drug. Dipeptidyl peptidase-4 inhibitors are oral lipid-lowering drugs with specific characteristics favouring their use in primary care. Among other characteristics, these drugs have few drug-drug interactions, can be easily combined with other drugs, are well tolerated, have a neutral effect on weight, and have a low risk of producing hypoglycaemic episodes, all of which encourages their prescrip-tion. Dipeptidyl peptidase-4 inhibitors are considered as second-line drugs (and as first-line drugs if metformin is contraindicated or poorly tolerated). In some specific situa-tions, this position could be threatened by the development of new drug families, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 analogues, which have shown benefits in reducing major cardiovascular events and mortality. It is important to determine the current place of dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes mellitus, since they have been increasingly prescribed in primary care in the last few years.