Koshizaka M, et al. - In this prospective, multicenter, open-label, blinded-endpoint, randomized controlled study, Among Japanese patients with type 2 diabetes treated with sitagliptin (HbA1c levels of 7-10%, and BMI ≥22 kg/m2), researchers examined the effectiveness of ipragliflozin (sodium-dependent glucose transporter-2 inhibitor) vs metformin for visceral fat reduction and glycemic control. The ipragliflozin group displayed significantly greater mean percent reduction in visceral fat area vs the metformin group (-12.06% vs -3.65%). Significant reduction in BMI, subcutaneous fat area, waist circumference, fasting insulin, and homeostatic model assessment (HOMA)-resistance, and increase in HDL-cholesterol levels were also reported among those receiving ipragliflozin. Significantly reduced HbA1c and LDL-cholesterol levels and increased HOMA-beta were noted among those receiving metformin. As per findings, the observed wide use of ipragliflozin or metformin in combination with dipeptidyl peptidase-4 inhibitors in Japan is suggested to have positive effects in lessening many cardiovascular risk factors.