While our results support the continued use of metformin as part of comprehensive risk-factor management in patients on ADT, they also call for prospective studies to test whether newer diabetes agents with proven cardiovascular benefit (e.g., GLP-1 receptor agonists, SGLT2 inhibitors) can reduce the disproportionate cardiovascular burden in this high-risk group. The gene discussed is SLC5A2; the disease is diabetes mellitus.