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Impaired glucose tolerance and diabetes mellitus may develop in some patients in this context, and insulin-sensitizers, such as metformin and thiazolidinediones, have become useful therapeutic approaches for the disease (3)

Combination of PIO with SLGT2 inhibitors Preclinical evidence The possible activities of ipragliflozin (IPRA), PIO or their combination on a variety of diabetic features (IR, hyperinsulinemia, obesity, dyslipidemia) and the progression to NASH were explored after their administration to high-fat diet-fed KK/A y T2D mice [113]

These agents act through multiple mechanisms, including direct cardioprotection, vasodilation, natriuresis, weight reduction, lipid profile improvement, anti-inflammatory effects, renal protection, reduction in plaque formation, and neurohormonal regulation [50]

Conclusion and Future Perspective The therapeutic benefits of GLP-1RAs in the management of DM extend well beyond glycemic control, offering a broad range of cardiovascular advantages