It remains unclear with no evidence to date whether it is appropriate and or safe to have a lower glycemic HbA1c target of below 52 mmol/mol (6.9%) for reduction in CKD onset or progression with novel agents such as GLP-1 RAs, dual GLP-1 RA and glucose-dependent insulinotropic polypeptide (GIP) agonist, or SGLT-2 inhibitors, which have lower burden of hypoglycemia. The gene discussed is GCG; the disease is chronic kidney disease.