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Diabetes and Your Heart
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Diabetes and heart disease often go hand in hand. Learn how to protect your heart with simple lifestyle changes that can also help you manage diabetes.
Heart disease is very common and serious. It's the leading cause of death for both men and women in the United States. If you have diabetes, you're twice as likely to have heart disease or a stroke than someone who doesn't have diabetes—and at a younger age. The longer you have diabetes, the more likely you are to have heart disease.
But the good news is that you can lower your risk for heart disease and improve your heart health by changing certain lifestyle habits. Those changes will help you manage diabetes better too.
Heart disease includes several kinds of problems that affect your heart. The term "cardiovascular disease" is similar but includes all types of heart disease, stroke, and blood vessel disease. The most common type is coronary artery disease, which affects blood flow to the heart.
Coronary artery disease is caused by the buildup of plaque in the walls of the coronary arteries, the blood vessels that supply oxygen and blood to the heart. Plaque is made of cholesterol deposits, which make the inside of arteries narrow and decrease blood flow. This process is called atherosclerosis, or hardening of the arteries. Decreased blood flow to the heart can cause a heart attack. Decreased blood flow to the brain can cause a stroke.
Hardening of the arteries can happen in other parts of the body too. In the legs and feet, it's called peripheral arterial disease, or PAD. PAD is often the first sign that a person with diabetes has cardiovascular disease.
Over time, high blood sugar can damage blood vessels and the nerves that control your heart. People with diabetes are also more likely to have other conditions that raise the risk for heart disease:
• High blood pressure increases the force of blood through your arteries and can damage artery walls. Having both high blood pressure and diabetes can greatly increase your risk for heart disease.
• Too much LDL ("bad") cholesterol in your bloodstream can form plaque on damaged artery walls.
• High triglycerides (a type of fat in your blood) and low HDL ("good") cholesterol or high LDL cholesterol is thought to contribute to hardening of the arteries.
None of these conditions has symptoms. Your doctor can check your blood pressure and do a simple blood test to see if your LDL, HDL, and triglyceride levels are high.
These factors can also raise your risk for heart disease:
• Smoking
• Being overweight or having obesity
• Not getting enough physical activity
• Eating a diet high in saturated fat, trans fat, cholesterol, and sodium (salt)
• Drinking too much alcohol
People with diabetes are also more likely to have heart failure. Heart failure is a serious condition, but it doesn't mean the heart has stopped beating; it means your heart can't pump blood well. This can lead to swelling in your legs and fluid building up in your lungs, making it hard to breathe. Heart failure tends to get worse over time, but early diagnosis and treatment can help relieve symptoms and stop or delay the condition getting worse.
Your blood pressure, cholesterol levels, and weight will help your doctor understand your overall risk for heart disease. Your doctor may also recommend other tests to check your heart health, which could include:
• An electrocardiogram (ECG or EKG) to measure your heart's electrical activity. Your heartbeat is the result of an electrical impulse traveling through your heart.
• An echocardiogram (echo)to examine how thick your heart muscle is and how well your heart pumps.
• An exercise stress test (treadmill test) to see how well your heart functions when it's working hard.
These lifestyle changes can help lower your risk for heart disease or keep it from getting worse, as well as help you manage diabetes:
Follow a healthy diet. Eat more fresh fruits and vegetables, lean protein, and whole grains. Eat fewer processed foods (such as chips, sweets, and fast food) and avoid trans fat. Drink more water, fewer sugary drinks, and less alcohol.
• Aim for a healthy weight. If you're overweight, losing even a modest amount of weight can lower your triglycerides and blood sugar. Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person.
• Get active. Being physically active makes your body more sensitive to insulin (the hormone that allows cells in your body to use blood sugar for energy), which helps manage your diabetes. Physical activity also helps control blood sugar levels and lowers your risk of heart disease. Try to get at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking.
• Manage your ABCs:
• A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
• B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
• C: Manage your cholesterol levels.
• s: Stop smoking or don't start.
• Manage stress. Stress can raise your blood pressure and can also lead to unhealthy behaviors, such as drinking too much alcohol or overeating. Instead, visit a mental health counselor, try meditation or deep breathing, get some physical activity, or get support from friends and family.
Your doctor may also prescribe medicines that can help keep your blood sugar, blood pressure, cholesterol, and triglycerides close to your target levels.
Work with a diabetes care and education specialist for help avoiding health complications such as heart disease. You'll get support and solutions and hear about the latest advances in managing diabetes. Find out more about how diabetes education can help you take the best care of yourself. And be sure to ask your doctor for a referral if you don't already have a diabetes educator.
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