The review question was structured according to the Population, Intervention, Comparison, and Outcome (PICO) framework [10]: Population - adults with T2DM, with or without cardiovascular disease; Intervention - glucose-lowering drugs including SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, and metformin; Comparator - placebo, insulin, or active comparator drugs; Outcomes - mechanistic cardiovascular endpoints such as oxidative stress biomarkers, echocardiographic or cardiac MRI measures, vascular stiffness, and biochemical mediators of myocardial remodeling. This evidence concerns the gene INS and type 2 diabetes mellitus.