Seniors with type 2 diabetes or those with diabetic complications were less likely to be hospitalized for heart failure while taking a sodium-glucose co-transporter 2 (SGLT2) inhibitor compared to dipeptidyl peptidase-4 (DPP4) inhibitors, another new class of oral antidiabetic drug, according to a study released in Cardiovascular Diabetology and conducted by Anthem, Inc. and HealthCore. The study is the first to report a direct comparison of SGLT2 and DPP4 inhibitors on the risk of heart failure hospitalization. People with type 2 diabetes are at increased risk of serious health complications, and the risk of heart failure alone is four- to fivefold higher among patients with diabetes than those without the condition. Patients with diabetes also face a higher risk of recurrent heart failure, compared with people without diabetes. Food and Drug Administration guidelines recommend doctors evaluate patients for cardiovascular risk before prescribing medication to manage diabetes. SGLT2 inhibitors and DPP4 inhibitors are the latest addition to the type 2 diabetes treatment arsenal and are recommended as second-line treatment after metformin. Both SGLT2 and DPP4 inhibitors have received attention for their effect on cardiovascular outcomes, with clinical trials finding a reduction in cardiovascular events, including heart failure admissions with empaglifozin and canagliflozin – both SGLT2 inhibitors -- compared to placebo. However, there has been very limited information on how these findings compare to patients who use other medications. The HealthCore study found that the heart failure hospitalization risk is 32% lower for new users of SGLT2 compared to DPP4 medications. In most patients younger than 65 or without history of diabetic complications, there was no risk difference. The majority of the analyzed patients were younger than 65, or didn’t have complications, and there was no risk difference among those. The study analyzed medical and pharmaceutical data from October 2012 to October 2016, including adults who filled a new prescription for SGLT2 or DPP4 medication classes between April 2013 and December 2014. After matching to ensure the two cohorts were balanced for age, sex and other clinical characteristics, there were 4,899 people in the SGLT2 cohort and 9,798 in the DPP4 cohort. Both groups were followed for approximately two years after beginning medication.