Second, compared with other antidiabetic drugs, these agents are often prescribed to patients with high cardiovascular risk, chronic kidney disease, or obesity, making it challenging to adequately address confounding by indication, although an active comparator new-user study design may help alleviate this issue.132Comparing SGLT2 inhibitors to GLP-1 receptor agonists could be an option, as these drugs are sometimes considered alternatives.11 This evidence concerns the gene SLC5A2 and obesity due to melanocortin 4 receptor deficiency.