Summary: Every three years American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) publish their report regarding current recommedantions for type 2 diabetes treatment. The 2018 edition saw major changes, including the rule of selecting second oral agent according to the presence or absence of the macro- or microvascular complications. In patients with these conditions SGLT-2 inhibitors should neb preferred out of oral agents, while in patients without vascular complications other oral agents can be used. The costs of therapy has also been acknowledged as an important determinant of treatment choice.