IntroductionCardiovascular diseases are the leading cause of death in people with type 2 diabetes. The assessment of additional risk factors for cardiovascular disease among diabetes patients and comparing current practices with the best practices can improve patient care. The aim of this study was to assess these additional risk factors and awareness of them among adult patients with diabetes mellitus. Materials and methodsThis cross-sectional study was conducted in the general medical wards at District General Hospital Kilinochchi from June 2021 through August 2021 and included 421 patients. The data were analyzed using SPSS version 28. ResultsMost patients (70.1%) were women, and their mean age was 57.4 years. Their lifestyle-related risk factors included being overweight (9%) or obese (2.1%), smoking (8.8%), consuming alcohol (2.4%), insufficient physical activity (23.5%), and not meeting the Sri Lankan dietary guidelines for the consumption of fruits and vegetable (75.3%). In addition, 3.3% were suffering from chronic kidney disease, 6.2% from microalbuminuria, 49.4% from hypertension, and 67.7% from hypercholesterolemia. Further, 11.4% (CI: 8.6-11.7%) had uncontrolled diabetes, only 40.1% had low-density lipoprotein (LDL) levels within the target range, and only 16.2% had systolic blood pressure within the target range. ConclusionsThe findings presented here indicate the existence of significant gaps similar to those found in the literature regarding lifestyle modifications and recommended practices for reducing the risk of cardiovascular disease. As a result, it may be necessary to address physicians' inertia in regard to the implementation of best practices, and there is a clear need to educate patients during their visits to reinforce the importance of lifestyle modifications.