What is the Connection Between Diabetes and Heart Disease?
Key takeaways:
Diabetes is a major risk factor for heart disease, but having your diabetes under control can help.
Heart disease may feel different for people with diabetes, so it is important to know the warning signs.
Diet, exercise, and medications are crucial to lowering your risk of heart disease.
Heart disease is a broad term that includes many different problems related to the heart and blood vessels. Heart disease is the leading cause of death in the U.S., and diabetes raises your risk of heart disease. In fact, adults with diabetes are twice as likely as adults without diabetes to die from heart disease. These statistics can be scary and intimidating, but fortunately there are steps you can take to lower your risk of heart disease. Read on for answers.
How does diabetes raise your risk of heart disease?
Diabetes alone raises the risk of heart disease. Over time, the high blood glucose levels that come with diabetes damage the blood vessels that supply oxygen to the heart. High blood glucose can also damage the nerves that control the heart, and can even change the structure of the heart.
Diabetes can also be associated with other “silent” diseases that raise your risk of heart disease. This means that, even when your blood glucose is not high, you are still at a higher risk for heart disease than you would be if you didn’t have diabetes.
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Does type 2 diabetes affect the heart?
Type 2 diabetes greatly affects the heart in two major ways. In addition to the damaging effect of high blood glucose on blood vessels and nerves, people with type 2 diabetes are also much more likely to have other conditions that affect the heart and raise the risk of heart disease:
Abnormal cholesterol levels: High levels of LDL (“bad”) cholesterol and triglycerides and low levels of HDL (“good”) cholesterol raise the risk of heart disease. High cholesterol leads to plaque buildup in your heart.
Hypertension: High blood pressure raises the risk of heart disease by increasing pressure and strain on blood vessels. People with both high blood pressure and diabetes may have double the risk of heart disease.
Obesity: Obesity is a risk factor for heart disease on its own, and also makes type 2 diabetes worse by increasing insulin resistance.
Does type 1 diabetes affect your risk of heart disease?
People with type 1 diabetes also have an increased risk of heart disease. Experts suggest that the main threat to the heart and blood vessels in type 1 diabetes comes from high blood glucose levels. This is different from type 2 diabetes, in which the risk of heart disease seems to be related to abnormal cholesterol levels, high blood pressure, and excess weight, in addition to high blood glucose levels.
Does prediabetes increase the risk of heart disease?
Prediabetes is when your blood glucose levels are higher than normal, but not high enough to meet the criteria for true diabetes. Prediabetes is not a disease itself, but it does mean that you have an increased risk for developing type 2 diabetes. But that’s not all: Recently, studies have shown that people with prediabetes are more likely to have a heart attack, a stroke, and other serious cardiovascular diseases than are those with normal blood sugar levels.
What are the warning signs of heart disease in people with diabetes?
The connection between diabetes and heart disease is strong, and recognizing warning signs of a heart attack can be life-saving.
People with diabetes may experience any of the common signs of a heart attack, like:
Chest pain that radiates to the left arm or shoulder
Chest pressure
Difficulty breathing or shortness of breath
New swelling in the legs
But people with diabetes, and especially women, may have different signs of heart disease that may be harder to diagnose. These include:
Excessive sweating without explanation
Dizziness or lightheadedness
Nausea
Jaw pain
How is heart disease prevented in people with diabetes?
Learning about the connection between diabetes and heart disease can be scary, but the good news is that there are measures you can take to prevent heart disease. Keeping your blood glucose levels in check is one of the best preventive measures. This can be done through diet, exercise, and medications.
Diabetic diets reduce inflammation associated with high blood glucose levels and heart disease. Exercise helps control blood glucose levels even without weight loss. Exercise lowers blood pressure, reduces stress and inflammation, and strengthens muscles — all of which are great for your heart. Exercise also helps with blood circulation, so your heart does not have to work so hard to “pump.”
And, even though it’s hard, quitting smoking is vital. Did you know that smoking causes one in every four deaths from cardiac disease? Quitting smoking is one of the most important things you can do to protect your heart. Even if you have been smoking for years, it’s never too late to quit or cut back.
Additionally, focusing on keeping your cholesterol levels, blood pressure, and weight in check will significantly help decrease your risk for heart disease. Your healthcare provider may recommend starting treatment for these conditions early if you also have diabetes.
Medications that treat both heart disease and diabetes
Prescription medications that treat diabetes, high blood pressure, and abnormal cholesterol levels can help lower your risk of heart disease, even if you feel well:
Aspirin: Although aspirin is no longer recommended for everyone, it may be recommended if you already have certain heart conditions. Because aspirin is not entirely risk-free, it’s best to talk to your healthcare provider about whether aspirin is right for you.
Statins: The American Diabetes Association currently recommends statins for nearly everyone with diabetes to help prevent heart disease and strokes.
Other medications: Depending on your situation, certain blood pressure medications may help to protect your heart.
The bottom line
Having diabetes puts you at a higher risk for heart disease, but this risk can be managed. Staying on top of your diabetes is key. For many people, this means taking medication. A diabetic and heart-healthy diet, along with exercise, can go a long way. It is also very important to make sure you get checked regularly for high blood pressure, high cholesterol, and obesity, as these are more common with diabetes and can make your heart risks skyrocket. Cut back on smoking and alcohol to keep the risk of heart disease as low as possible. Being familiar with signs and symptoms of heart disease can be lifesaving.
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References
Arnett. D. K. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Journal of the American College of Cardiology.
Centers for Disease Control and Prevention. (2022). Diabetes and your heart.
Low Wang, C. C., et al. (2019). The missing link for cardiovascular disease in type 1 diabetes mellitus? Hyperglycemia-induced cardiac autoimmunity. American College of Cardiology.
Mando, R. (2021). Prediabetes as a risk factor for major adverse cardiovascular events. Annals of Medicine.
Petrie, J. R., et al. (2019). Excess cardiovascular risk in type 1 diabetes mellitus. Circulation.
