A new analysis using data from the Department of Veterans Affairs' Million Veteran Program (MVP) found individuals living with type 2 diabetes had a substantially lower risk of major adverse cardiovascular events when they used a GLP‑1 receptor agonist in combination with several healthy lifestyle habits. The study represents the first large‑scale effort to evaluate how medication and lifestyle factors jointly influence heart health in this population.
Researchers reviewed health, lifestyle, and prescription information from more than 98,000 adults with type 2 diabetes and no prior cardiovascular disease between 2011 and 2023. MVP's integrated dataset, linking survey responses, electronic health records, and long‑term follow‑up, enabled investigators to assess eight core lifestyle behaviors: healthy eating, regular physical activity, adequate sleep, not smoking, moderate alcohol use or alcohol avoidance, good stress management, strong social connection, and absence of opioid use disorder.
The study found that both GLP‑1 medication use and adherence to healthy lifestyle habits were independently associated with reduced cardiovascular risk. Individuals who adopted all eight lifestyle habits had a 60% lower risk of major cardiovascular events, while GLP‑1 users had a 16% lower risk. Veterans who used a GLP 1 medication and followed six to eight healthy habits had a 43% lower risk of major cardiovascular events than those who followed fewer healthy habits and did not use a GLP 1 medication.
The findings reinforce longstanding guidance that lifestyle behaviors play a central role in diabetes management and overall cardiovascular health. The results also highlight how lifestyle‑based approaches can complement newer therapeutic options available to patients.
The study notes several limitations, including its observational design and a study population drawn largely from male Veterans. However, results were similar across demographic groups.
The study was published in The Lancet Diabetes & Endocrinology on February 25, 2026.
Reference: "Combined associations of GLP‑1 medications and a healthy lifestyle with cardiovascular outcomes among individuals with diabetes"
