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7 In patients who meet these criteria, the ADA preferably recommends use of a GLP-1 RA with proven cardiovascular benefit or an SGLT-2 inhibitor with proven cardiovascular benefit provided they have adequate kidney function

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Scientific Reference 4 (Circadian / Microbiome Rhythm & Stability): Thaiss et al., Science (2016) This research highlights that disrupting circadian–microbial oscillations impairs metabolic homeostasis, glucose regulation, microbial balance, and stability — illustrating why long-term metabolic health requires rebuilding the microbiome and circadian/metabolic rhythms, not just using drugs