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What is already known on this topic Hyperkalemia is associated with increased mortality and limits the use of guideline recommended drugs such as renin-angiotensin system inhibitors among people with type 2 diabetes Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase-4 (DPP-4) inhibitors are increasingly being used in the treatment of type 2 diabetes The comparative effectiveness of these drugs in preventing hyperkalemia in routine clinical practice is unclear What this study adds In this population based cohort study of people with type 2 diabetes in the United States, starting SGLT-2 inhibitors or GLP-1 receptor agonists was associated with a lower risk of hyperkalemia compared with DPP-4 inhibitors Benefits were consistent among demographic and clinical subgroups, and among single agents within the SGLT-2 inhibitor and GLP-1 receptor agonist classes In addition to improving cardiovascular and kidney outcomes, the potential benefit of preventing hyperkalemia further solidifies the use of SGLT-2 inhibitors and GLP-1 receptor agonists in people with type 2 diabetes Ethics statements Ethical approval This study was approved by the Mass General Brigham institutional review board and granted waiver of informed consent since only deidentified claims data were used