CAC-Based Treatment

Standard-arm participants and their GPs are blinded to CAC results and continue usual contemporary diabetes guideline care. The high-risk intervention centers on cardioprotective drug combinations that were unavailable in prior trials. High-risk and very-high-risk participants in the CAC-based arm start treatment during study site visits and then transition to GP-led management. Low-risk participants with CAC scores from 1 to 99 receive no specific study intervention beyond standard guideline care. Very-low-risk participants with CAC equal to zero receive recommendations for less intensive treatment, but the patient and GP make the final decision.