Which population is most likely to benefit from cardio-renal benefits of SGLT2 inhibitors independent of glycemic status?

• A. Young healthy individuals.
• B. Patients with heart failure with reduced ejection fraction.
• C. Patients with type 1 diabetes.
• D. Patients without cardiovascular disease.

Answer: (B)

SGLT2 inhibitors provide cardio-renal benefits beyond lowering blood glucose, thanks to mechanisms like diuresis, natriuresis, reduced preload and afterload, favorable renal hemodynamics, and improved myocardial energy efficiency. These effects translate into fewer heart failure–related hospitalizations and slower kidney function decline, and they occur regardless of diabetic status. The strongest evidence is in patients who already have heart failure with reduced ejection fraction, where trials show reduced cardiovascular death and HF hospitalizations in both diabetic and non-diabetic individuals. Therefore, the population most likely to benefit independent of glycemic status is those with heart failure with reduced ejection fraction.