In this issue (P94), Kutoh reports type 2 diabetic patients who showed changes in cardiac function which is concomitant with changes in ketone bodies by using one of sodium glucose cotransporter 2 inhibitors (SGLT2i), tofogliflozin [1], proposing a possible mechanism for SGLT2i-mediated prevention of heart failure. EMPA-REG OUTCOME trial showed a striking relative risk reduction in hospitalizat...