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Introduction Evidence from trials and real-world studies in patients with type 2 diabetes (T2D) indicates that the risk of complications may be reduced by providing sustained glycemic control and that near-normal glycated hemoglobin (HbA 1c ) levels should be achieved as early as possible in the T2D trajectory ( 1c above desired targets: mean percent time spent with HbA 1c 7% was 40% in the first 2 years and 61% after 610 years ( Reasons that may be responsible for the lack of improvement in glucose levels over time include failure to address the complex pathophysiology of T2D, therapeutic inertia leading to delayed treatment intensification, insufficient implementation of lifestyle changes, and poor adherence to and persistence with treatment ( Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a well-established class of glucose-lowering agents that induce glucose-mediated stimulation of insulin secretion, reduce glucagon release, reduce hepatic glucose output, delay gastric emptying, increase satiety, and improve cardiovascular risk factors (69)

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