Peter Attia prefers the mechanism of action of SGLT2 inhibitors over metformin for longevity, as SGLT2 inhibitors do not appear to impair the benefits of exercise.

“and i'm actually my interest in this even goes a bit beyond that of metformin which has historically garnered much of the longevity attention in the diabetes medication repurposed camp because i like the mechanism of action more i like what it doesn't do again i think metformin is an amazing drug i think it's its efficacy in people with diabetes is remarkable i do have my concerns about its efficacy in very healthy people who exercise at the upper limit of what we've discussed and i think it might it might impair there i think it's too soon to say we're actually in the process of designing a study now to test that but to me this is a drug that doesn't really show any evidence of impairing the benefits of exercise and yet offers through totally different mechanisms some of those cardio protective benefits”