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Relevant English-language studies were identified through PubMed, Scopus, Web of Science, Embase, and Google Scholar up to May 2025 using combinations of the terms GLP-1 receptor agonist, SGLT2 inhibitor, gut microbiota, type 2 diabetes, renal, and cardiovascular. Both preclinical and clinical investigations were considered, with an emphasis on peer-reviewed studies addressing microbiota composition, metabolite shifts, and systemic effects