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According to the American Diabetes Association (ADA) Standards of Care, a GLP-1 RA should be considered in T2D patients who have not met glycemic goals on metformin, especially if additional factors are present such as atherosclerotic cardiovascular disease (ASCVD), heart failure, or chronic kidney disease

Its not the drug that breaks down the collagen

Najahi H, Alessio N, Squillaro T, Conti GO, Ferrante M, Di Bernardo G, et al

In conclusion, the BP lowering effect of DPP-4i may be reduced by stimulating sympathetic activity via reducing degradation of GLP-1 and substance P when combined with ACEI, especially in high-dose ACEI