This review analyzes the research results of additional effects and mechanisms of action of sugar-reducing drugs. Hence it has been suggested that asymmetric dimethylarginine may be a target molecule for metformin, vildagliptin, and combinations thereof. (For citation: Urakov AL, Gurevich KG, Sorokina IA, et al. Metformin and vildagliptin combination: a new approach of endothelial nitric oxide synthase activity regulation and metabolism in diabetes mellitus type 2. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(2):5-12. doi: 10.17816/RCF1625-12).