This week, we explore the potential role of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with systemic lupus erythematosus (SLE) and comorbid type 2 diabetes (T2D)—a population historically excluded from landmark SGLT2i trials. Our guest, Dr. Karen Costenbader, discusses the rationale behind the study, the nuances of trial emulation design, and key findings regarding cardiovascular and renal outcomes, infection risk, and prescribing patterns in this complex cohort. We also unpack implications for clinical decision-making and the evolving landscape of metabolic and cardiovascular care in autoimmune disease.