There are very few studies evaluating the beneficial effects of metformin on the development of heart failure in diabetic patients or comparing its cardiac effect profile head-to-head with those of agents such as sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, whose positive cardiovascular effects have been well established. Here, SLC5A2 is linked to heart failure.