Table 1 Clinical trials have shown that intervention measures reduce the risk of major vascular complications in patients with T2DM

Lifestyle interventions

Medical nutrition therapy

All-cause mortality, CVD mortality events, stroke

7–32%

[63, 121, 123]

Weight reduction

Cardiometabolic diseases, cardiac diastolic function

0.84–2.45times

[131, 133]

Increased physical activity

Including different types of physical activity (dynamic aerobic exercise (126/248 trials), dynamic resistance exercise (25/248 trials), and combined aerobic and resistance exercise (58/248 trials))

All-cause mortality: median 6 months:

15 fewer per 1.000 (22 fewer to 6 fewer);

[135]

Cardiovascular mortality: median 12 months

24 fewer per 1.000 (35 fewer to 11 fewer);

Myocardial Infarction: median 12 months

8 fewer per 1.000 (16 fewer to 3 more);

Stroke: median 3.6 months:

2 fewer per 1.000 (10 fewer to 9 more)

Including different types of physical activity (total physical activity, leisure-time physical activity, moderate-to-vigorous physical activity, and walking)

Total CVD incidence

A high compared with low level of physical activity was associated with a 16%

[136]

Coronary heart disease incidence

A high compared with low level of physical activity was associated with a 16%

Cerebrovascular events

A high compared with low level of physical activity was associated with a 26%

heart failure incidence

A high compared with low level of physical activity was associated with a 24%

Pharmacological prevention

Glycemic management

Macrovascular event (coronary heart disease, heart failure, stroke, and peripheral arterial disease)

0%-39%

[146, 147]

macrovascular events (Myocardial Infarction, Congestive Heart Failure, stroke, angina, and revascularization)

8–48%

[148]

Metformin

Heart Failure

18%

[154]

GLP-1RAs

Stroke, MACE, all-cause and cardi138ovascular mortality

12–72%

[149, 151, 158, 165]

SGLT-2 inhibitors

All-cause and cardiovascular mortality, serious heart failure events

16–40%

[158, 159]

Combined medication

Dual therapy(metformin + DPP-4i/sulfonylurea/SGLT2i/GLP-1-RA/basal insulin)

MACE

36–79%

[167]

Triple therapy ( metformin + DPP-4i + sulfonylurea/SGLT2i + GLP-1-RA/GLP-1-RA 1 basal insulin)

38–83%

Lipid management

Statins

Nonfatal myocardial infarction

43%

[177]

IPE/EPA

ASCVD

4.8–23.3%

[179, 180]

Blood pressure management

MACE, all-cause mortality, cardiovascular death

13–34% (Each 1-SD) SBP

[187, 189,190,191,192]

Thrombosis treatment ( Antiplatelet drugs (Aspirin/P2Y12 receptor antagonists/Other antithrombotic approaches) with or without anticoagulant drugs (rivaroxaban))

all-cause death, stroke, myocardial infarction, MACE

8.7–39%

[62, 195, 197, 198]