Sato Y, et al. - Researchers used an analysis of covariance model to examine predictors of the initial response of beta-hydroxybutyrate (BHB) and maximum BHB (max-BHB) values during long-term therapy with the SGLT2 inhibitor, tofogliflozin, and analyze the relationship of the initial elevation of BHB with subsequent clinical effects in those with T2DM. The study sample consisted of 774 candidates (mean age was 58.5 years) receiving tofogliflozin in Phase 3 trials in two groups (top quartile [n = 194] and 3 lower quartiles [n = 579]) based on measurable BHB change at week 4 (initial response). Findings suggested that during long-term tofogliflozin therapy lower basal insulin secretion capacity could predict higher initial BHB elevations and max-BHB levels. High initial BHB elevations could be associated with greater weight loss by lipid use.