This is likely due to the fact that about 70% of T2DM patients in the Palermo LHU were cared for only by GPs, who may prescribe only first-generation ADs, despite updated guidelines recommending as second-line therapies more recent and higher-cost drugs, such as DPP4i, GLP1-RA and SGLT2i. This evidence concerns the gene GLP1R and type 2 diabetes mellitus.