If you have type 2 diabetes, you know that keeping an eye on your blood glucose (sugar) is an important part of managing the disease. But did you know that having diabetes also makes you more prone to having heart disease or a stroke?

It’s true. In fact, cardiovascular disease is the No. 1 cause of death among people with type 2 diabetes. Compared with those who don’t have diabetes, women with the condition have about 4 times greater risk for heart disease, while men with the condition have about twice the risk.

So, in addition to watching and controlling your blood glucose, take steps to protect your heart health:

  • Ask questions
  • Know your risk of heart disease or stroke
  • Learn what you can do to stay healthy

If you or a loved one is living with diabetes, use this resource to learn more about the condition and how to manage your heart disease risk.

Living With Diabetes

There’s plenty you can do to help keep diabetes in check while also slowing or preventing other health problems. Get some practical tips about controlling your weight, eating healthy, and staying active on our healthy living pages.

Having diabetes means you have too much sugar—called glucose—in your blood. If untreated, diabetes can harm the body, particularly the heart and vascular system. In fact, people with diabetes are 2-4 times more likely to have heart disease or suffer a stroke than those who don’t have the disease. Experts say this risk is even greater for women with diabetes.

Diabetes can lead to heart attacks, strokes, kidney disease, blindness, dental disease, amputations, and other serious health problems. And the longer you have high levels of blood glucose traveling around your body, the more likely you are to have problems.

If you have diabetes, the best thing you can do is learn about how to manage your condition and prevent problems.

What Increases Your Risk?

Several things can make someone more likely to develop type 2 diabetes. For example:

  • Being overweight or obese—the more weight you carry, especially around your midsection, typically the more resistant your body is to insulin
  • Having high blood pressure generally or during pregnancy (called preeclampsia)
  • Eating an unhealthy diet that is high in fat, calories, cholesterol and processed food
  • Not exercising regularly
  • Being older than 45, although it can occur in younger people
  • Having a parent, brother or sister who has diabetes
  • If you are a woman, a few more factors can increase your risk:
    • Being diagnosed with gestational diabetes
      • Up to 3 out of 5 women who had this during pregnancy will go on to develop diabetes within 15 years
    • Giving birth to a baby that weighed more than 9 pounds
    • Having polycystic ovarian syndrome (PCOS)

Type 2 diabetes is also more common among certain ethnic or racial groups including African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders.

It’s important to talk with your health care professional about all your personal risk factors.

If you’re like most people, you may not know that diabetes and heart disease often go hand-in-hand.

Diabetes is a major risk factor for cardiovascular disease, including:

  • Coronary heart disease
  • Heart attack
  • Stroke
  • Weakening of the heart muscle (cardiomyopathy)
  • Heart failure

The ways in which diabetes affects cardiovascular health are complex. But we do know that high levels of sugar in the blood can, over time, damage the blood vessels and nerves. These changes can make your blood vessels stiff and narrowed. As a result, blood may not flow as easily to your heart, brain or body.

Unfortunately, by the time someone learns they have diabetes, changes or injuries to the large (macro) or small (micro) blood vessels in the body have often already started. Talking with your care team about these changes is important.

  • Microvascular complications include diabetes-related kidney disease, vision and nerve problems
  • Macrovascular complications include heart attack, stroke and peripheral artery disease

People with diabetes are also more apt to have other heart disease risk factors. For example:

  • High blood pressure
  • Elevated levels of low density lipoprotein (LDL) cholesterol
  • Chronic kidney disease that can lead to dialysis
  • Being overweight or obese

By the Numbers

  • 1 out of 10: Britains living with diabetes
  • 2X-4X: How much more likely people with diabetes are to develop heart disease or stroke compared with people who don’t have diabetes
  • 2 out of 3: Proportion of deaths due to heart disease among people older than 65 with diabetes

Because diabetes and heart disease are linked, treatment plans for diabetes shouldn’t focus only on controlling blood sugar levels. Treatment must address other cardiovascular risk factors, too. This approach might include:

  • Ongoing assessment of cardiovascular health (for example, watching cholesterol panels, blood pressure or protein in the urine)
  • Steps to help protect your heart health with lifestyle changes (for example regular exercise, heart-healthy diet, good sleep habits) and possibly medications to help control high blood pressure or cholesterol
  • Referrals to other providers to support a coordinated, team-based approach to your care
  • Routine vaccination against the flu and pneumonia to prevent illnesses that can stress the heart

Do You Have Heart Disease?

If you have heart disease but haven’t been screened for type 2 diabetes, ask to be tested. Many people with heart disease also have diabetes, but they often remain undiagnosed.

The sooner you know, the sooner you can take steps to lower your risk. Many people have prediabetes, an early warning sign for diabetes. At this stage, they can make changes to help prevent the onset of the disease.

People with type 2 diabetes are more likely to develop heart disease or have a stroke compared with those who don’t have diabetes—and at a younger age.

Diabetes is among the strongest risk factors for heart and vascular disease. It’s right up there with smoking and having high blood pressure or high cholesterol.

Having diabetes means you have too much sugar (also called glucose) in your blood. It can affect the way your heart works, and harm blood vessels. For example, the lining of the blood vessels may become thicker, which can impair blood flow. Many people have poor blood flow in their legs and feet, which can lead to numbness and weakness. Diabetes can damage other organs as well, including the kidneys.

Diabetes and heart disease share many of the same risk factors, such as having high cholesterol, being overweight, not exercising and smoking.

If you have diabetes, it doesn’t mean heart disease is bound to happen. In many cases, there are steps you can take to keep your diabetes in check and stay ahead of heart disease. But it’s not always easy. If you have or develop heart disease, then you will have to manage several conditions, which can seem daunting.

Managing diabetes is a team effort. You will likely be seen by a number of health professionals, and making sure everyone if on the same page is important.

Be sure to ask your health care team about how to best manage your risk of cardiovascular disease. Here are some questions you might consider asking during your next visit.

  • How does Type 2 Diabetes change my risk for other diseases, including cardiovascular disease?
  • What changes can I make to prevent heart problems or stroke?
  • In addition to my blood pressure and cholesterol levels, what should I watch for?
  • Do I need to try to lose weight? How much?
  • Could medications help protect my heart?
  • How often should my heart health be checked? What tests would you recommend?
  • Could I benefit from seeing a nutritionist?
  • Should I keep taking my vitamins and supplements?
  • In addition to my A1C, are there other blood sugar tests that I’ll need?
  • I heard statins may cause diabetes. Is this true?
  • What support groups and resources are available to me?


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