It was not until the Empagliflozin Reduces Mortality in Patients With Type 2 Diabetes at High Cardiovascular Risk (EMPA-REG OUTCOME) trial was published in November 2015 that SGLT-2 inhibitors first demonstrated additional cardiovascular benefits.8 The cardiovascular benefits of GLP-1 receptor agonists were not proven until June 2016.9 Thus, the diffusion of second-generation diabetes drugs as initial therapy between 2007 and 2015 affords a unique opportunity to describe the diffusion and drivers of early drug adoption absent of clear evidence of clinical superiority. The gene discussed is GLP1R; the disease is diabetes mellitus.