**8.5 SGLT2 inhibitors**

Among therapies in clinical trials for women with PCOS are the sodium-glucose cotransporter-2 inhibitors (SGLT2i), which are antidiabetic agents. SGLT2i has recently been shown to be superior to metformin for weight loss in women with PCOS [133]. Additionally, SGLT2i is cardioprotective in patients with T2DM or with heart failure [134]. For example, in the EMPA-REG trial, SGLT2i reduced the relative risk of cardiovascular death by 38% in patients with T2DM on the background of the blockade of the renin-angiotensin system (RAS) [135]. A possible mechanism to explain why SGLT2i has dramatic cardiovascular protection includes its interactions with the RAS, which is affected by sex steroids and is a major regulator of BP [45, 136].
