People with type 2 diabetes face higher risk of heart disease, including heart attack and stroke. Many are now using GLP-1 medications (such as some injectable diabetes and weight-management drugs), and others focus on diet and exercise. A large new study shows that doing both — medication and lifestyle together — is associated with the lowest cardiovascular risk, and that lifestyle matters even for people who do not use these medications.
What the study found
Researchers from Harvard T.H. Chan School of Public Health and the U.S. Department of Veterans Affairs (VA) used data from the Million Veteran Program (2011–2023) to look at over 98,000 adults with type 2 diabetes and no prior cardiovascular disease. They examined how GLP-1 receptor agonists (GLP-1 RAs) — a class of diabetes and weight-management medications — and healthy lifestyle habits were related to the risk of major cardiovascular events: non-fatal heart attack, non-fatal stroke, or death from cardiovascular causes.
The results, published in The Lancet Diabetes & Endocrinology (February 2026), show:
- Combining GLP-1 RA use with six to eight healthy habits was associated with about 43% lower risk of major cardiovascular events compared with not using a GLP-1 RA and following three or fewer habits.
- Following all eight healthy habits was associated with about 60% lower risk compared with following one or fewer habits.
- GLP-1 RA use alone was associated with about 16% lower risk compared with non-use.
So both medication and lifestyle contributed, and the strongest benefit was seen when both were in place. Experts, including from the American Heart Association, stress that lifestyle and medication are complementary — neither replaces the other.
The eight habits
The study defined eight healthy lifestyle factors. Each one was linked with better cardiovascular outcomes:
- Healthy diet — Eating a balanced, nutrient-rich diet that supports blood sugar and heart health.
- Regular exercise — Getting consistent physical activity (e.g. as recommended by your doctor or guidelines).
- Not smoking — Avoiding tobacco in any form.
- Restful sleep — Prioritizing enough good-quality sleep most nights.
- Minimal alcohol intake — Limiting or avoiding alcohol.
- Good stress management — Using healthy ways to cope with stress (e.g. relaxation, support, activity).
- Social connection and support — Maintaining meaningful relationships and a support network.
- No opioid use disorder — Not misusing prescription or illicit opioids.
You do not have to do everything at once. Small, steady steps in any of these areas can help.
Understanding the findings
People with type 2 diabetes are at higher risk for heart disease; initiatives like the American Heart Association and American Diabetes Association "Know Diabetes by Heart" campaign highlight this link. The new study adds evidence that lifestyle remains central to heart health and that GLP-1 medications and healthy habits work together.
Limitations to keep in mind: The study used observational data (it did not randomly assign people to treatment or lifestyle). Participants were largely from the VA system and mostly male, so results may not apply equally to everyone — though the researchers reported that findings were generally consistent across groups. As with any single study, it is one important piece of evidence among many.
What you can do
- Talk to your doctor about your heart disease risk, your diabetes management, and whether a GLP-1 medication is appropriate for you. Ask how lifestyle changes can support your heart health.
- Focus on one or two habits at a time rather than trying to change everything at once. Even small improvements are associated with better outcomes.
- Remember that medication does not replace lifestyle. Both matter; lifestyle is something you can work on regardless of which medicines you take.
- Use trusted sources for information: your healthcare team, and reputable organizations such as the American Diabetes Association, American Heart Association, and your national health authority.
Lifestyle and treatment together can significantly reduce cardiovascular risk for many people with type 2 diabetes. Every step you take toward healthier habits counts.
Sources
- Nguyen X-MT, et al. "Combined associations of GLP-1 medications and a healthy lifestyle with cardiovascular outcomes among individuals with diabetes." The Lancet Diabetes & Endocrinology, February 25, 2026. DOI: 10.1016/S2213-8587(25)00395-X.
- Harvard T.H. Chan School of Public Health and the U.S. Department of Veterans Affairs have issued news releases on this research; the American Heart Association has also presented related findings (e.g. at AHA Scientific Sessions 2025). Check their official websites for the latest summaries.
Remember: Tabibu Health provides health information only. Always consult a qualified healthcare professional for diagnosis, treatment, and personalized advice.