Moreover, large trials such as SELECT (semaglutide in obesity without diabetes; n = 17 604) [7] and across the SURPASS program (tirzepatide in type 2 diabetes, n = 7769) [8] did not report EKA, suggesting that if a risk exists, it is very rare and typically requires additional modifiers such as SGLT2 inhibition, very low carbohydrate intake, or sustained vomiting/starvation. Here, SLC5A2 is linked to type 2 diabetes mellitus.