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Although most guidelines continue to recommend metformin as first-line anti-hyperglycemic therapy, the European Society of Cardiology [52] recommends that GLP-1RA or SGLT2i should be first-line therapy in individuals with ASCVD or at high or very high CV risk

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GLP-1RA binding to GLP-1R, which is mainly expressed in pancreatic islets, can promote insulin synthesis and secretion, stimulate -cell proliferation, and inhibit apoptosis (Figure 4 demonstrated that the PRR for thyroid neoplasms malignant was also increased in this combination therapy

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