Diabetes mellitus (DM) is a major public health issue and a significant risk factor for atherosclerotic cardiovascular disease (ASCVD), which contributes to up to 80 % of deaths in individuals with diabetes.1 The elevated risk is primarily due to hyperglycemia-induced inflammation, oxidative stress, and endothelial dysfunction, leading to increased coronary plaque burden and rupture risk. Coronary Computed Tomography Angiography (CCTA) enables detailed assessment of plaque burden using metrics …