A new article published in Diabetes Therapy elaborated on diabetes being the leading cause of chronic kidney disease, and even in the absence of albuminuria, decreased renal function in T2DM patients increases the risk for major adverse cardiovascular events and death. This article reported on the evidence derived from recent studies which suggests that intensive glucose control not only reduces the risk for microalbuminuria and macroalbuminuria but may also decreases the rate of decline of glomerular filtration rate (GFR). It was discussed that though insulin therapy is widely used in patients with T2DM and renal disease, metabolic control is difficult to achieve and manage because of the limited therapeutic options and frequent comorbidities found in this population. Recent evidence have indicated that dipeptidyl peptidase-4 (DPP-4) inhibitors, such as vildagliptin, may offer a better choice for improving glycemic control in T2DM patients with low GFR. It was stated that, vildagliptin, with appropriate dose adjustment, provides clinically important reductions in glycated hemoglobin, without increasing weight and the risk of hypoglycemia even in patients with severe chronic kidney disease.