Based on the data from randomized clinical trials and all available real-world evidence, we hypothesised that SGLT2 inhibitor use may be linked to a lower risk of all-cause mortality in metformin users when compared to sulfonylurea users. In this study, we compared the efficacy of SGLT2 inhibitors versus sulfonylureas in reducing the risk of all-cause mortality in patients receiving metformin therapy using electronic health care databases from the US Department of Veterans Affairs, another class of medication used to regulate blood glucose is sulfonylureas. Patients with functional beta cells are the only ones who benefit from these medications. They don't work for everyone with diabetes, and they might eventually stop working for some people. There are two additional categories for sulfonylureas: first-generation and second-generation. The use of first-generation sulfonylureas is decreasing due to the availability of more potent medications. Furthermore, they may now be linked to a rise in cardiovascular deaths and Second-generation sulfonylureas have a number of benefits over first-generation ones, such as being safer for patients with renal impairment because they are eliminated in the urine and bile, not interfering with many protein-bound medications, and having a longer half-life. Hypoglycemia can be caused by any sulfonylurea.