{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:07:45Z","timestamp":1792080465048,"version":"4.4.0"},"reference-count":102,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health of the Czech Republic, conceptual development of research organization","award":["65269705"],"award-info":[{"award-number":["65269705"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Diabetes mellitus increases the risk of developing coronary artery disease, stroke, aortic disease, heart failure, atrial fibrillation, and peripheral arterial disease. This condition negatively impacts prognosis by increasing the risk of future cardiovascular (CV) events. Patients with type 2 diabetes mellitus need a comprehensive and personalized assessment and definition of the CV risk profile. In very high-risk individuals, special attention is required due to the high risk of adverse events despite appropriate management and treatment. Key interventions to reduce this risk include CV prevention and cardiac rehabilitation. Traditional and non-traditional CV risk factor management, dietary modifications, regular physical activity, aerobic and resistance exercise training, psychosocial and frailty management, optimal pharmacological therapy, and investigation of comorbidities are recommended to reduce the development of CV disease and mortality. Therefore, our manuscript provides updated and critical evidence on the comprehensive management of patients with type 2 diabetes mellitus in clinical practice from the perspective of CV prevention and cardiac rehabilitation, with a focus on individuals at very high risk. Further, practical guidance on individualizing exercise prescriptions based on patient-specific risk profiles and comorbid conditions is provided.<\/jats:p>","DOI":"10.3390\/jcm14217791","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:30:27Z","timestamp":1762198227000},"page":"7791","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac Rehabilitation and Cardiovascular Prevention in Patients with Type 2 Diabetes Mellitus: From Initial Assessment to Comprehensive Management"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-3320","authenticated-orcid":false,"given":"Cristina Andreea","family":"Adam","sequence":"first","affiliation":[{"name":"Department of Medical Specialties I, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, University Street No. 16, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-8391","authenticated-orcid":false,"given":"Joanna","family":"Popiolek-Kalisz","sequence":"additional","affiliation":[{"name":"Department of Clinical Dietetics, Medical University of Lublin, ul. Chodzki 7, 20-093 Lublin, Poland"},{"name":"Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, al. Krasnicka 100, 20-718 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9878-256X","authenticated-orcid":false,"given":"Buket","family":"Akinci","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, 34015 Istanbul, Turkey"},{"name":"Biruni University Research Center (B@MER), Biruni University, 34015 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0676-3132","authenticated-orcid":false,"given":"Giovanna","family":"Manzi","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Policlinico Universitario Umberto I, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-101X","authenticated-orcid":false,"given":"Irfan","family":"Ullah","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0464-3607","authenticated-orcid":false,"given":"Eirini","family":"Beneki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1005 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-9327","authenticated-orcid":false,"given":"Florin","family":"Mitu","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, University Street No. 16, 700115 Iasi, Romania"},{"name":"Academy of Medical Sciences, 030167 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 700050 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-1541","authenticated-orcid":false,"given":"Ladislav","family":"Batalik","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic"},{"name":"Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic"},{"name":"Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic"},{"name":"Department of Rehabilitation, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2448-1799","authenticated-orcid":false,"given":"Marina","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1418-7908","authenticated-orcid":false,"given":"Francesco","family":"Perone","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Rehabilitation Clinic \u2018Villa delle Magnolie\u2019, 81020 Castel Morrone, Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2730","DOI":"10.1016\/j.numecd.2022.09.008","article-title":"Clinical Complexity and Diabetes: A Multidimensional Approach for the Management of Cardiorenal Metabolic Syndrome","volume":"32","author":"Mattina","year":"2022","journal-title":"Nutr. 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