Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are an exceptionally versatile class of medication, and their glycemic and nonglycemic benefi ts could help millions of patients with type 2 diabetes. Of note, they have been shown to improve cardiac and renal outcomes, muchneeded benefi ts in patients with type 2 diabetes, who are at a higher risk for developing cardiac and renal dysfunction than those who do not have diabetes. The indications for SGLT-2 inhibitors may continue to expand as ongoing clinical trials provide more insight into these drugs. KEY POINTSSGLT-2 inhibitors improve glycemic control, reduce hospitalizations for heart failure, and slow the progression of renal disease.Consider an SGLT-2 inhibitor as fi rst-or second-line therapy (after metformin) in patients with type 2 diabetes with cardiovascular disease or renal disease, or both, regardless of glycemic control.Consider an SGLT-2 inhibitor in overweight or obese patients with type 2 diabetes.Be aware of the possibility of genital infections and diabetic ketoacidosis with SGLT-2 inhibitor use.

Objective Diabetes mellitus is associated with microvascular and macrovascular complications; the most commonly recognized ones include diabetic nephropathy, retinopathy, and neuropathy. Less well-known complications are equally important, as timely recognition and treatment are essential to decrease short- and long-term morbidity. Methods Herein, we describe a case of a 41-year-old female with longstanding, uncontrolled type 2 diabetes, who presented with classical findings of diabetic myonecrosis. Results Our patient underwent extensive laboratory and imaging studies prior to diagnosis due to its rarity and similarity in presentation with other commonly noted musculoskeletal conditions. We emphasize the clinical presentation, laboratory and imaging findings, treatment regimen, and prognosis associated with diabetic myonecrosis. Conclusion Diabetic myonecrosis is a rare complication of longstanding, poorly controlled diabetes mellitus. The diagnosis requires a high index of suspicion in the right clinical setting: acute onset nontraumatic muscular pain with associated findings on clinical exam, laboratory studies, and imaging. While the short-term prognosis is good, the recurrence rate remains high and long-term prognosis is poor given underlying uncontrolled diabetes and associated sequelae.

Glucagon-like peptide-1 (GLP-1) receptor agonists improve glycemic control in patients with type 2 diabetes mellitus, have cardioprotective and renoprotective effects, and do not cause weight gain or signifi cant hypoglycemia. In fact, they have been found to be effective for weight loss in patients with obesity with and without diabetes. They are now the preferred drugs to add to the regimen when oral metformin by itself is not enough to meet the patient's hemoglobin A1c goal.