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NICE NG28 recommends prioritising SGLT-2 inhibitors in people with established atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease often alongside or instead of metformin due to these organ-protective effects [10] [8] GLP-1 receptor agonists (e.g., semaglutide, liraglutide) generally produce greater HbA1c reductions (1.01.5%) and significant weight loss, but are injectable and more costly

Lancet 385 , 956965 (2015)

Collectively, these studies suggest that selective targeting of myostatin has therapeutic potential in preserving muscle as part of pharmacologic weight management