Tuttle KR, et al. - Type 2 diabetes mellitus (T2DM) is the leading cause of chronic kidney disease (CKD). The prevalence of CKD is growing in parallel with the rising number of patients with T2DM globally. At present, the optimal approach to glycemic control in patients with T2DM and advanced CKD (categories 4 and 5) remains uncertain, since these patients were largely excluded from clinical trials of glucose-lowering therapies. Nonetheless, clinical trial data are available for the use of incretin therapies, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, for patients with T2DM and advanced CKD. Researchers performed this review to describe the role of incretin therapies, dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists, in the management of patients with T2DM and advanced CKD. As the presence of advanced CKD considerably elevates the risk of cardiovascular disease (CVD) in patients with T2DM, treatment strategies for reduction of both CKD and CVD risks should be utilized given the higher likelihood for death, particularly of cardiovascular causes, than progression to end-stage kidney disease among these patients. Findings emphasize the essentiality of the management of hyperglycemia for good diabetes care even in advanced CKD. As per evidence gained, patients with T2DM and advanced CKD should be managed with an individualized approach to glycemic management, taking into account the requirements of each patient, including the presence of comorbidities and concomitant therapies.