Social media use duration and epigenetic aging among U.S. adults in the MIDUS refresher study.

Type 2 diabetes mellitus (T2DM) remains a profound global health crisis, projected to affect 853 million adults by 2050. The burden is disproportionately concentrated in low‐ and middle‐income countries (LMICs), where cardiovascular disease (CVD) remains the primary driver of mortality [, , , ]. Hyperglycaemia‐related cardiovascular deaths underscore the urgent need for therapies providing benefits beyond glycaemic control [, ]. The burden of diabetes is concentrated in low‐ and middle‐income countries, where delayed diagnosis, limited access to care and high out‐of‐pocket costs contribute to poorer outcomes [, , ]. Globally, an estimated 252 million people remain undiagnosed, nearly 90% residing in LMICs [, , ]. Pakistan currently faces the highest age‐standardised diabetes prevalence globally, affecting approximately 34.5 million people (31.4% of adults). This crisis is compounded by a 27% undiagnosed rate, low healthcare expenditure (< USD 100 per capita) and high out‐of‐pocket costs, leading to over 225 000 annual deaths [, , , ]. While ADA/EASD guidelines recommend glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) like semaglutide for their superior cardiorenal and weight‐loss benefits, innovator semaglutide remains inaccessible for most Pakistani patients due to high acquisition costs [, , ]. The SUSTAIN clinical trial programme and real‐world evidence from high‐income countries have confirmed semaglutide's robust efficacy, typically achieving HbA1c reductions of 1.2%–1.8% and significant weight loss. However, this ‘treatment gap’ persists in LMICs [, , , ]. In the cardiovascular outcomes trial SUSTAIN 6, semaglutide reduced the risk of major adverse cardiovascular events by 26% compared with placebo in patients with T2DM at high cardiovascular risk [, , ].