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Recognizing the strong link between obesity, T2DM, and HFpEF, the 2025 American Diabetes Association (ADA) Standards of Care granted a Level A recommendation for GLP-1 RAs with demonstrated benefit, specifically semaglutide, for reducing HF symptoms and physical limitations in patients with T2DM and obesity.(11) More recently, the SUMMIT trial showed that tirzepatide significantly reduced the composite risk of major HF events, including hospitalization and cardiovascular (CV) death, suggesting that dual GIP/GLP-1 agonism may further optimize outcomes.(14) However, the 2025 ADA Standards of Care reference only semaglutide as the GLP-1 RA with demonstrated benefit based on the evidence from the STEP-HFpEF trial program

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