Understanding the Diabetes-Heart Disease Connection


October 6, 2022

Diabetes-Heart Disease Connection

Did you know heart disease and stroke are the leading causes of death in people with diabetes?

Diabetes and heart disease often go hand in hand. Diabetes doubles the risk of heart disease and stroke as the two conditions share many of the same risk factors, including obesity, high blood pressure (hypertension), and high cholesterol and triglyceride. 

How diabetes affects heart health

The connection between diabetes and heart health is twofold. First, it can directly increase your risk of heart disease, as high blood sugar — the defining feature of diabetes — can gradually damage your blood vessels and the nerves that control your heart, increase inflammation, and disrupt the normal blood flow to the heart. Secondly, diabetes may increase your risk for other heart-related conditions, specifically:

  • High blood pressure, which occurs when the force of the blood flowing through your arteries is consistently too high, causing the heart to work harder. Damaged blood vessels as the result of diabetes can lead to high blood pressure. According to the American Diabetes Association, two out of three individuals with diabetes have high blood pressure or take blood pressure-lowering medication.
  • 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.

Unfortunately for caregivers, NONE of these conditions have visible symptoms! For this reason, it’s important to stay on track with preventative screenings and to monitor blood pressure and cholesterol levels.

What is heart disease?

The term heart disease refers to several conditions that affect the heart:

  • Coronary artery disease — the most common type of heart disease — occurs when the blood vessels that supply the heart with oxygen-rich blood are hardened or blocked, affecting blood flow to the heart.
  • Peripheral arterial disease is characterized by a similar hardening of the arteries in the legs and feet. It is often the first sign of cardiovascular disease in an individual with diabetes.
  • Heart failure occurs when the heart cannot pump blood and oxygen as well as a healthy heart, often due to damaged heart muscle or blocked arteries.
  • A stroke occurs when the flow of blood and oxygen to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels.

Diabetes is one of several primary drivers of heart disease, along with uncontrollable risk factors like age and family history as well as controllable ones such as:

  • Smoking
  • Physical inactivity and obesity
  • High cholesterol
  • High blood pressure

Symptoms of heart disease

If you have any condition that falls under the umbrella of diabetes — including prediabetes, type 1 diabetes, or type 2 diabetes — it’s important to learn the symptoms of heart disease. These are among the most common:

  • Chest pain, tightness, or pressure
  • Shortness of breath
  • Fainting, dizziness, or lightheadedness
  • Fatigue
  • Rapid or slow heartbeat
  • Pain in one or both arms
  • Numbness or weakness in your legs

Heart disease presents differently from one individual to another. However, if you have diabetes and experience any of the symptoms above — especially chest pain or pressure, shortness of breath, or fatigue — it’s important to seek prompt medical care.

Decreasing your risk for heart disease

The longer a person has uncontrolled diabetes, the higher their risk of heart disease. If you have diabetes, there are several steps you can take to lower your risk of heart disease. First and foremost, stay proactive about your diabetes treatment and work with your doctors to keep blood sugar levels in a healthy range.

There’s a useful acronym to help you remember important diabetic preventative actions — aka the ABCs:

  • A: A1C test – The A1C test measures your average blood sugar levels over the past three months. Work with your doctor to identify your personal target range.
    • Normal = below 5.7%, Prediabetes = 5.7% to 6.4%, Diabetes = 6.5%
  • B: Blood Pressure – Stay on track with blood pressure screenings. Your doctor can help you understand your personal goal. However, a healthy range for those with diabetes is typically considered under 140/90 mm Hg.
  • C: Cholesterol – Staying on track with cholesterol screenings and keeping LDL levels in a healthy range. As with your A1C and blood pressure levels, follow your doctor’s guidance regarding your personal target for cholesterol.
  • S: Smoking – Don’t smoke as it narrows your blood vessels, worsening diabetes and increasing your risk for heart disease. Ask your doctor for support with smoking cessation if needed.

In addition, follow a heart-healthy diet:

  • Opt for foods that are low in saturated fats and trans fats, which increase LDL cholesterol levels. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats.
  • Try to limit your sodium intake to 1,500 mg/day. Common sources of sodium include processed or prepackaged foods like soups, cold cuts, bread, and frozen meals.

When it comes to nutrition and diabetes, there isn’t a one-size-fits-all approach. Eating for diabetes and heart disease prevention involves choosing foods that reduce blood pressure, overall cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting blood sugar levels. The ideal balance of calories from carbohydrates, proteins, and fats varies significantly by individual, so it’s important to consult your doctor about the approach that best supports your treatment plan. Consider working with a nutritionist or diabetes educator, a healthcare professional with extensive knowledge of diabetes who is certified to provide individualized coaching.

Sources: Medical News Today, Alto Pharmacy, the CDC, and https://www.cdc.gov/diabetestv/

We hope this information is helpful to you in the important work you do as a family caregiver.
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