Finally, combining therapies with proven event reduction (e.g., SGLT2i) with interventions that modify the adipose-myocardial substrate (incretin-based agents and structured weight loss), alongside multimarker monitoring—sST2 as a dynamic remodeling marker, Galectin-3 for residual fibrosis, and GDF-15 as a stress/adaptation index with prognostic value—offers a scalable pathway to optimize care in T2D at risk for HF. Here, LGALS3 is linked to type 2 diabetes mellitus.