Can common diabetes drugs shield the heart? AI and Real-World data seek answers

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Phase 1: Retrospective Cohorts Inclusion Criteria: * Adults aged 19 years or older. * Diagnosis of type 2 diabetes mellitus. * New initiation of a study medication, including an SGLT2 inhibitor, a GLP-1 receptor agonist, or another eligible glucose-lowering medication. * At least 180 days of observable data before the index date, defined as the date of the first eligible prescription. Exclusion Criteria: * Type 1 diabetes mellitus or secondary diabetes mellitus. * Use of a medication from the same drug class within 90 days before the index date. * Pregnancy recorded during the relevant study period. * A history of the outcome being evaluated during the baseline period, applied separately for each outcome analysis. Phase 2: Prospective SGLT2 Inhibitor Validation Cohort Inclusion Criteria: * Adults aged 50 years or older receiving outpatient care at Dongtan Sacred Heart Hospital. * Diagnosis of type 2 diabetes mellitus. * No current or previous signs or symptoms of heart failure and New York Heart Association functional class I. * At least one of the following high-risk characteristics: diabetes duration of 5 years or longer, hypertension, body mass index of 25 kg/m² or higher, urinary albumin-to-creatinine ratio of 30 mg/g or higher, estimated glomerular filtration rate below 60 mL/min/1.73 m², or diabetic microvascular complications. * No previous treatment with an SGLT2 inhibitor and scheduled to initiate an SGLT2 inhibitor based on the treating physician's clinical judgment. * Ability and willingness to provide written informed consent. Exclusion Criteria: * Current or previous diagnosis of heart failure, hospitalization for heart failure, clinically suspected signs or symptoms of heart failure, or screening left ventricular ejection fraction below 50%. * Moderate or severe valvular heart disease, known hypertrophic, dilated, or infiltrative cardiomyopathy, complex congenital heart disease, or clinically significant pericardial disease. * Acute coronary syndrome, coronary revascularization, or stroke within 3 months before enrollment. * Presence of a pacemaker, implantable cardioverter-defibrillator, or cardiac resynchronization therapy device. * Atrial fibrillation, sustained tachycardia, frequent premature contractions, or another arrhythmia that prevents reliable comparison of ECG or global longitudinal strain measurements. * Type 1 diabetes mellitus, secondary diabetes mellitus, diabetic ketoacidosis within the previous year, or another clinical condition making SGLT2 inhibitor treatment inappropriate. * Estimated glomerular filtration rate below 30 mL/min/1.73 m² or dialysis. * Echocardiographic image quality insufficient for reliable 3-view global longitudinal strain or stage B heart failure assessment. * Pregnancy or breastfeeding. * Unwillingness to undergo study assessments or inability to complete the 6-month follow-up.