GLP-1RAs have been shown to increase ACE2 expression and activity, and downregulate the expression of ANG II production.54 It may also protect the kidneys by limiting the ANG II-i nduced tissue fibrosis by altering the expression of its receptor subtypes, ANG II receptor type 1 and ANG II receptor type 2.55 Finally, GLP-1 may lower ANG II-i nduced oxidative stress in a PKA-dependent pathway.54 Future trials testing the efficacy of GLP-1RAs on the prevention of DN in youth-onset T2D is needed to expand management strategies for this vulnerable population. This evidence concerns the gene AGT and liver dysplastic nodule.