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As diabetes is a major risk factor for CKD [67], specialized expert groups such as the Kidney Disease: Improving Global Outcomes (KDIGO) team, with the endorsement of both ADA and EASD, recommend that glycemic management for T2D patients with CKD should involve a combination of metformin and a SGLT-2 inhibitor as first-line therapy, with other drugs such as SUs considered only when additional therapies are needed for optimum glycemic control [68]

Combined therapy requires baseline and periodic monitoring of testosterone levels, hematocrit, blood glucose, HbA1c, blood pressure, and metabolic parameters

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As such, the side chain of E14 Cagri rotates slightly downwards and reduces the number of H-bonds with R17 Cagri