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The life history theory assumes that all organisms are under selective pressure to harvest external resources and allocate them to maximise fitness: only organisms making the best use of energy obtain the greatest fitness benefits. The trade-off of energy spans four functions: maintenance, growth, reproduction, and defence against pathogens. The innovative antihyperglycaemic agents glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors decrease bodyweight and have the potential to counter low-grade inflammation. These key activities could rewire two components of the life history theory operative in adulthood-ie, maintenance and defence. In this Personal View, we postulate that the benefits of these medications on the cardiovascular system, beyond their glucose-lowering effects, could be mediated by the reduction of the maintenance cost driven by obesity and efforts spent on blunting low-grade inflammation.

Supplementary table and figures forSex differences in cardiovascular disease and cardiovascular risk estimation in patients with type 1 diabetes (JCEM 2023)

Additional file 1: Figure S1. Correlations between CD62P+ MPs and fasting glucose level in all groups. Statistical significance was determined with linear regression. Dotted lines indicated the 95% of interval confidence. Figure S2. a–c Representative Western blots and densitometric analysis of PAR-1 and PAR-4 protein expression in platelets from NGT, GGC and PGC. The results were expressed relative to the control on the same blot, defined as 100%, and by the protein of interest/β actin densitometric ratio. The p-values were evaluated by ANOVA: PAR-1, p = 0.9; PAR-4, p