The current evidence regarding the renal and CV benefits of these new therapeutic groups (SGLT2i, and especially GLP1-RA) and the possibility of their administration to insulinized patients with DKD, paves the way for new scenarios in which insulin doses can be reduced, or even withdrawn in patients with obesity, or in those with adequate insulin reserve (measured by baseline C-peptide or after intravenous glucagon stimulation). This evidence concerns the gene GCG and obesity due to melanocortin 4 receptor deficiency.