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In this pharmaceutical industry funded study, patients with diabetes and worsening heart failure benefitted from the initiation of sotagliflozin therapy. 1222 patients underwent randomization to sotagliflozin or placebo. Those receiving sotagliflozin had a lower rate of hospitalization and death from cardiovascular disease, however, overall mortality was not statistically significantly improved. Comment: This study suggests that SGLT2 inhibitors may be of benefit when started immediately after an episode of acute heart failure in type 2 diabetics. There was a non-significant trend towards improved mortality but this was not statistically significant and remains an open question. What we do not clearly know is whether other SGLT2 inhibitors have the same benefit as sotagliflozin in this setting. Also, there is some evidence that SGLT2 inhibitors may work in non-diabetics with the onset of heart failure. Sotagliflozin is unique in that it is an SGLT1 and SGLT2 inhibitor, so it inhibits both the sodium glucose co-transporter 1 in the gut, and the sodium glucose co-transporter 2 in the kidneys. It is available in Europe but not in the US. N Engl J Med . 2020 Nov 16.    (retrieved Jan, 2021). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.