LAUSR

that degrades several vasoactive peptides, including natriuretic peptides), on glycemic and metabolic parameters, insulin resistance, and echocardiographic parameters in patients with prediabetes and heart failure with reduced ejection fraction (HFrEF). Their results suggest that sacubitril/valsartan improves metabolic control and insulin resistance in this population. These results are consistent with a meta-analysis that demonstrated the ef fi cacy of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in reducing the risk of new-onset type 2 diabetes (8). The increase in natriuretic peptides with neprilysin inhibition may further promote insulin sensitivity and improve glycemic control (9), as elegantly discussed in the paper by Cloro et al. Further studies should evaluate if neprilysin inhibition could have a role in preventing or treating prediabetes in individuals without heart failure