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Given the results from recent studies, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommend that patients with T2D and clinical cardiovascular disease (CVD) with inadequate glucose control despite treatment with metformin should receive an SGLT2 inhibitor or GLP-1 receptor agonist

Funding Funding was provided by Fralin Biomedical Research Institute at Virginia Tech Carillion

The resulting increase in intracellular NAD+ availability activates sirtuins particularly SIRT1, which regulates insulin sensitivity, gluconeogenesis, cholesterol synthesis, and fatty acid oxidation, and SIRT3, which governs mitochondrial antioxidant defences and energy metabolism