This case is 78-year-old female patient with type 2 diabetes (T2D), cardiovascular disease (CVD), hypertension, dyslipidemia and previous treatment of percutaneous coronary intervention (PCI). She maintained stable status until autumn 2024 with HbA1c 6.8-7.0%. She developed chest oppression, and then received cardiovascular evaluation. Pulse wave velocity (PWV) showed normal cardio-ankle vascular index (CAVI), about 1.0 with following up as ankle brachial pressure index (ABI), and no acute changes of in-stent restenosis (ISR) as coronary artery angiography (CAG). Low carbohydrate diet (LCD) has showed protective effect for arteriosclerotic development. Novel concept of Cardiovascular-Kidney-Metabolic Syndrome (CKM) has been introduced for the future