A post-marketing study showing that sodium glucose cotransporter-2 (SGLT-2) inhibitors trump other glucose-lowering medications in cutting cardiovascular risk could shake up how diabetologists and cardiologists treat type-2 diabetes. Researchers from Cambridge, UK-based AstraZeneca sifted through records of more than 300,000 patients across six countries in the CVD-REAL study presented at the American College of Cardiology's Annual meeting in Washington, DC, on March 19. The investigators found that the SGLT-2 inhibitors slashed heart failure hospitalization rates by 39% compared with other diabetes treatments and cut deaths from any cause by 51%. The SGLT2s targeted by these drugs are located in the proximal tubule of the nephron. SGLT-2 inhibitors thus lower blood glucose by a novel mechanism: they block glucose reabsorption in the kidney. The first SGLT-2 inhibitor to market was AstraZeneca and Bristol-Myers Squibb's Forxiga (dapagliflozin), approved in November 2012 in Europe. (Nat. Biotechnol. 31, 469–470, 2013). Other approved SGLT-2 inhibitors include Johnson & Johnson's Invokana (canafliflozin) and Eli Lilly/Boehringer Ingelheim's Jardiance (empagliflozin). In this study, more than 90% of patients were on Forxiga or Invokana. Merck and Pfizer are also collaborating to bring an SGLT2 rival drug, ertugliflozin, to market as well as on two combinations containing the drug to treat type 2 diabetes.