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According to a major meta-analysis of over 100 prospective studies, diabetes increases the risk of coronary heart disease, stroke, and mortality from other vascular causes by nearly a two-fold margin. Furthermore, it has been well established for roughly 30 years that diabetes alone substantially raises the risk of cardiovascular death compared to non-diabetics, regardless of the number of significant CV risk factors.

Therefore, one of the key issues facing health systems around the world is reducing CV morbidity and mortality in diabetes patients, with the resulting direct and indirect cost reductions.

The clinical management of diabetic patients involves the majority of diabetic patients from the time of the diagnosis of the disease and becomes progressively crucial in individuals at higher CV risk.

According to the most recent ESC/EASD guidelines, diabetic patients may have a moderate, high, or extremely high CV risk. The guidelines' elimination of the difference between primary and secondary CV prevention in high-risk diabetic individuals is one of its most clinically significant features. Until recently, practically all randomised clinical trials (RCTs) included a distinction between participants based on whether or not they had previously experienced a cardiovascular incident. Instead, the ESC/EASD guidelines declare that subjects on secondary prevention with existing CV illness and diabetic patients with multiple risk factors or even one organ damage belong to the same very high CV risk group. In light of this, this new stance of scientific organisations undoubtedly simplifies the therapeutic management of risk variables in diabetes patients, and could perhaps

Current research shows that multifactorial intensive treatment can lower major adverse cardiovascular events (MACEs) and overall mortality in type 2 diabetic participants with albuminuria and diabetic retinopathy (DR) on primary CV prevention (NID-2) study [4]. As a result, a multicenter RCT has demonstrated for the first time that a diabetic group on primary CV prevention, but characterised ante litteram at very high CV risk, benefits from multimodal intensive treatment.

It is not yet obvious, though, if a steady rise in the number of risk factors that are at goal has an impact on how patients fare. The current post-hoc analysis of the NID-2 study aims to assess the association between the quantity of risk factors that exceeded the specified threshold and patient CV outcomes.