Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. Management of patients with type 2 diabetes and CKD involves lifestyle modifications, glycemic control tailored to individual HbA₁c targets, reduction of cardiovascular risk, and prevention of kidney function decline. Metformin and sodium-glucose cotransporter 2 inhibitors (SGLT2i) are considered first-line agents for glycemic control, while glucagon-like peptide-1 receptor agonists (GLP-1 RAs) serve as second-line therapies. When selecting other antidiabetic medications, factors such as patient condition, comorbidities, drug cost, and risk of hypoglycemia should be carefully considered. This narrative review discusses current treatment strategies for glycemic control in patients with type 2 diabetes and CKD, with a focus on key clinical considerations and guideline recommendations