Furthermore, it can be hypothesized that GLP-1 RAs reduce atherosclerotic plaque vulnerability in diabetes by promoting sirtuin 6 (SIRT6) expression, increases in collagen content, adiponectin secretion, and its anti-inflammatory effects through adaptor protein PH domain and leucine zipper containing 1 (APPL1) signaling pathways (Balestrieri et al., 2015; Barbieri et al., 2017). Here, SIRT6 is linked to diabetes mellitus.