Diabetes and Heart Disease

What is the link between diabetes and heart disease?

Diabetes is a disorder in which your body does not make enough insulin or is unable to use insulin properly. This causes the level of sugar in your blood to become very high. If blood sugar stays high for a long time, the inner lining of blood vessels may be damaged. This makes it easier for cholesterol to build up, forming plaques in the walls of the blood vessels that supply oxygen and nutrition to the heart.

Cholesterol plaques can break apart or rupture, causing blood clots and blocking the blood vessel. This can lead to chest pains (called angina) or a heart attack. Diabetes can also slightly weaken the heart muscle itself. This can cause heart failure, which means that the heart is not able to pump enough blood.

If you have diabetes:

• You are 2 to 4 times more likely to have a heart attack or stroke than someone without diabetes, and you are more likely to have it at an earlier than average age.
• If you have a heart attack, you are more likely to die from the heart attack.

What can I do to lower my risk?

Talk with your provider about any questions or fears you may have. Follow the treatment plan your healthcare provider prescribes. Here are some of the things you can do to lower your risk of heart disease:

• Control your blood sugar. Keeping your blood sugar levels within the proper ranges can prevent or delay blood vessel damage.
• Control your blood fats (cholesterol and triglycerides). Unhealthy levels of blood fats also cause heart disease. This effect happens faster and is usually worse when you have diabetes. People with diabetes often have high levels of triglycerides and low levels of HDL (good cholesterol). When you have diabetes, try to keep your LDL (bad cholesterol) below 100 milligrams per deciliter (mg/dL) and triglycerides below 150 mg/dL. If you already have heart disease, your provider may recommend an LDL goal of less than 70 mg/dL. HDL should be above 40 for men with diabetes and above 50 for women with diabetes.
• Control your blood pressure. Nearly two-thirds of adults with diabetes have high blood pressure. Your blood pressure should be less than 130/80. Most people with diabetes often have to use 2 or more medicines to keep their blood pressure at that level.
• Lose weight if you are overweight, and stay at the lower weight. Weight loss can make it easier to control your blood sugar and blood pressure, and it can decrease your risk of heart disease.
• Exercise regularly according to your healthcare provider's instructions. Regular exercise can help you lose weight. It also helps reduce your risk of heart disease.
• If you smoke, quit. In people with diabetes, smoking triples the risk of dying from heart problems.
• Carry your medicine with you and know how to take it properly. It also helps to have a list of the names and doses of medicines that you are taking and the instructions for taking them.