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As a result, SGLT2 inhibitors are now recommended as first add-on (or even first-line, alongside metformin) when someone has established cardiovascular disease, heart failure, or chronic kidney disease: even if their HbA1c is at target

They are not a substitute for individual clinical judgment

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If so, the two types of heart failure may be very similar, except that the cause of heart failure with a preserved ejection fraction may not be the same as that with a reduced ejection fraction

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