Chilton RJ - Given that sodium-glucose cotransporter-2 inhibitors (SGLT-2is) were shown to mitigate the risks of cardiovascular (CV) and renal complications in patients with type 2 diabetes (T2D) and CV risk factors or CV disease (CVD), researcher evaluated the enhanced risk of CVD and renal disease in T2D patients and addressed the potential mechanisms for the cardioprotective and renoprotective effects of SGLT-2i therapy. The observed improvements in the CV and renal results with SGLT-2is in CVOTs indicate a class impact in this patient population and influenced guidelines on how to initiate add-on therapy to metformin in patients with T2D and high risk of CV. In patients with T2D and high CV risk, SGLT-2is' overall cardioprotective and renoprotective effects are most likely attributable to multiple mechanisms, including cardiac, hemodynamic, metabolic, anti-inflammatory, and renal effects.