GLP1R and diabetes mellitus: For these reasons, the ESC guidelines include strong recommendations for the use of SGLT2i and GLP-1 RA in patients with CCS and diabetes (Class I, LoE A) [72] and the new ADA guidelines recommend SGLT-2i and/or GLP1-RA for initial therapy, with or without metformin based on glycemic needs, in diabetic patients with high-risk features or established CV disease [78].