Semaglutide and Vascular Regeneration

Inclusion Criteria: 1. Adults ≥ 18 years of age who meet one of the following Health Canada indications to receive subcutaneous semaglutide injections: * Documented T2D with inadequate glycemic control * Body mass index (BMI) ≥ 30 kg/m\^2 (obesity) * BMI ≥ 27 kg/m\^2 (overweight) and at least one weight-related comorbidity, such as hypertension, dyslipidemia, or obstructive sleep apnea 2. AND meet one of the following ASCVD criteria: * History of ASCVD: * Documented coronary artery disease * Documented cerebrovascular or carotid disease * Documented peripheral artery disease * No ASCVD but has 2 or more of the following risk factors: * Cigarette smoker or stopped smoking within 3 months of screening * Persistent hypertension (defined as office blood pressure ≥ 140/90 mmHg) or currently on antihypertensive medications * BMI ≥ 27 kg/m\^2 * estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73m\^2 * Treated or untreated dyslipidemia * Triglyceride ≥ 2.0 mmol/L * HDL-C ≤ 1.0 mmol/L for men or ≤ 1.3 mmol/L for women * High sensitivity C-reactive protein (hsCRP) ≥ 2.0 mg/L * Documented micro- or macro-albuminuria * Self-identified South Asian ethnicity Exclusion Criteria: * Female subjects who are pregnant, planning pregnancy, or breastfeeding * HbA1c \> 11.0 % * Currently on a GLP-1RA or previously taken a GLP-1RA * Personal or family history of medullary thyroid carcinoma * Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) * New York Heart Association class IV symptoms of heart failure * Known history of severe liver disease (e.g. Child-Pugh Class B or C) * White blood cell count ≥ 15 x 10\^9/L * Active infectious disease requiring antibiotic or anti-viral agents * Known acquired immunodeficiency syndrome such as HIV * On oral steroid therapy (e.g. prednisone or other corticosteroids) or other immunosuppressive agents (e.g. methotrexate) * Any malignancy not considered cured (except basal cell carcinoma of the skin). A subject is considered cured if there has been no evidence of cancer recurrence for the 5 years prior to screening * Any clinically significant or unstable medical condition that might limit one's ability to complete the study or comply with the requirements of the protocol, including: dermatologic disease, hematological disease, pulmonary disease, hepatic disease, gastrointestinal disease, genitourinary disease, endocrine disease, neurological disease, and psychiatric disease