We speculate that the reason is that it can work mainly by renal way but not the islet cell like others B-cell independent OADs such as GLP-1 receptor agonists and DPP-4 inhibitors are not related to the risk of hypoglycemia when combining with insulin.[32] Patients with diabetes are at an increased risk of infections, Monami et al[33] reported that genital and urinary infections rather frequent but usually mild in SGLT2 inhibitors group that appeared to be well tolerated. Here, INS is linked to infection.