Accordingly, individuals with T2DM and established CV disease or with high CV risk indicators, including age ≥ 55 years with stenosis > 50% of the coronary, carotid, or lower extremity arteries, or with left ventricular hypertrophy should be treated with an SGLT2i or a glucagon-like peptide-1 receptor agonists (GLP1-RA) with demonstrated CV benefits regardless of HbA1c level or treatment with metformin. The gene discussed is GLP1R; the disease is left ventricular hypertrophy.