**Study Summary:** This research looks at two diabetes treatments: *zenagamtide* and *insulin glargine*. People with **type 2 diabetes** (a condition where the body doesn't use insulin properly) at higher risk for heart or blood vessel problems, who are on 1 to 3 diabetes pills, can join. Participants will get injections under the skin once a week. They will randomly get either zenagamtide (new medicine being tested) or insulin glargine (a medicine already in use). **Key Points:** - **Study Duration:** Weekly injections, exact number of visits not specified. - **Eligibility:** Must be 45+ years old, have type 2 diabetes, and be taking 1-3 diabetes pills. - **Safety:** Participants are monitored for health changes. **Eligibility Requirements:** To join, you must have had diabetes for at least 180 days and be at increased risk for heart issues. Some conditions like recent heart attacks or certain diabetes complications might prevent participation. Participants should not have been on certain diabetes treatments recently. This study helps researchers understand how well zenagamtide works compared to insulin glargine and its safety.