Diabetes mellitus is one of the most common chronic diseases globally responsible for increased morbidity and mortality. The global prevalence of diabetes among adults is estimated to be 6.4%, affecting 285 million people, in 2010, and is expected to increase to 7.7%, affecting 439 million people by 2030.

The position statement of the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) recommends the use of one of six commonly used antihyperglycemic agents i.e. 1) sulfonylurea (SU), 2) thiazolidinedione, 3) dipeptidyl peptidase-4 (DPP4) inhibitor, 4) sodium-glucose cotransporter-2 (SGLT2) inhibitor, 5) glucagon-like peptide-1 (GLP-1) receptor agonist, or 6) basal insulin analogue, as an add-on therapy when the individualized HbA1c target is not achieved after 3 months of treatment with metformin alone.

 Vildagliptin, a potent and selective inhibitor of dipeptidyl peptidase-4 (DPP-4), improves glycemic control by increasing the availability of endogenous incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Remogliflozin, a selective inhibitor of sodium-glucose cotransporter subtype 2 (SGLT2), which is to be administered as Remogliflozin Etabonate, the prodrug for Remogliflozin. Inhibition of SGLT2 (which is selectively expressed in the proximal convoluted tubules of kidney) leads to increased excretion of glucose in urine, resulting in reduced blood glucose concentrations and has therapeutic benefit in T2DM. Remogliflozin is available relatively at lower cost than the existing medications of same class being marketed in india. Remogliflozin thus can prove to be a cost-effective drug in treatment of type 2 diabetes mellitus in developing country like India.

This study is proposed with the hypothesis that remogliflozin may be non-inferior to vildagliptin in the treatment of type 2 diabetes mellitus.