The review gives detailed information on the state-of-the-art of hypoglycemia (HG) and the results of its Russian and international trials. It is noted that HG should be now regarded as an extremely undesirable glucose-lowering therapy complication that is closely related to the risk of cardiovascular events and higher mortality rates, worse glycemic control, and poorer quality of life in patients with type 2 diabetes mellitus (T2DM). The priority effective therapy tactics for T2DM is to manage the latter without any risk of HG, which can be implemented by the wide clinical application of incretins, dipeptidyl peptidase-4 inhibitors in particular, which have the glucose-lowering activity comparable with that shown by metformin and sulfonylurea drugs, are practically safe when used as monotherapy and significantly enhance the efficiency of therapy without substantially increasing the risk of severe HG when co-administered with other medications.
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