Diabetes is a major public health problem and is emerging as a pandemic. The prevalence of type 2 diabetes (DMT2) is significantly increasing in younger population, which is affected by obesity worldwide. There are eight core defects implicated in the pathogenesis of DMT2 commonly called the “Ominous Octet”. Pharmacologic therapy of DMT2 has changed dramatically in the last 10 years, with new drugs and drug classes becoming available. The cornerstone of diabetes therapy considers lifestyle changes with metformine added in the first line medication therapy. The second line therapy considers addition of second oral agent, GLP-1R agonist or insulin. A more comprehensive definition of treatment success in patients with DMT2 should include slowing or stopping disease progression and the reduction of all risk factors associated with microvascular and macrovascular diabetic complications (hypertension, obesity, hyperlipidemia, inflammation). We prefer antidiabetic drugs with direct positive impact on other cardiovascular risk factors not only on reducing glycated hemoglobin (HbA1c) and the ones with low risk of hypoglycemia. Incretins are a new innovative therapeutic option that includes GLP-1R agonists and DPP-4 inhibitors. These antidiabetic agents have a number of positive effects on multiple mechanisms involved in pathophysiology of the T2DM, including weight loss, reduction of blood pressure, beneficial effect on the lipid profile, potential regenerative effect on beta cells, and low risk of hypoglycaemia. Of great significance is the proven cardioprotective effect of some GLP-1R agonists.