International guidelines that have been updated in the light of CVOTs have recognised this distinction, recommending an SGLT2 inhibitor or GLP-1 receptor agonist with proven CV benefit for patients with T2D in an atherosclerotic CVD setting [37–39]; or an SGLT2 inhibitor with proven HF or CKD benefit in patients where HF or CKD predominates [37, 38]. Here, GLP1R is linked to hydrops fetalis.