3 Ways to Protect Your Heart With Type 2 Diabetes

Many of the steps that can help improve your diabetes also improve heart health. Here's what you need to know about cholesterol, blood pressure, and ways to protect your heart.

By Elizabeth Shimer Bowers

Medically reviewed by Pat F. Bass III, MD, MS, MPH

When you're managingtype 2 diabetes, your blood sugar levels aren’t the only thing you need to monitor — you also need to pay attention to your cholesterol and blood pressure, which are indicators of your heart health. That’s because people with diabetes are twice as likely as people without diabetes to develop heart disease. Protecting your heart health is an important part of managing type 2 diabetes.

How Type 2 Diabetes Affects the Heart

Diabetes and heart health have a strong connection. “When we treat diabetes, we are really treating a cardiovascular disease,” says Joel Zonszein, MD, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. “The major cause of death and complications in people with type 2 diabetes is heart disease.”

In fact, according to the American Heart Association (AHA), two out of three people with diabetes will eventually die from heart attack or stroke.

The reasons diabetes increases your risk for heart disease and stroke are complex. People with diabetes are at greater risk for high cholesterol, high blood pressure, and obesity. Research shows that these complications increase levels of inflammation, which makes cardiovascular events such as heart attack and stroke more likely.

“We look at not only improving blood sugar to prevent diabetes complications, but perhaps more importantly, at controlling blood pressure, cholesterol, and obesity to help protect the heart,” Dr. Zonszein says.

Zonszein adds that people with diabetes who suffer a heart attack are much more likely to die from it than people without diabetes “because of the micro vessel changes that occur with diabetes — the diabetic heart doesn’t recover well from a heart attack.”

Understanding Blood Pressure and Cholesterol Levels

Just because you have diabetes doesn’t mean you’re destined to have heart problems. You can help protect yourself by being particularly vigilant about your blood pressure and cholesterol levels.

For blood pressure, the American Diabetes Association (ADA) recommends:

• Systolic lower than 120 millimeters of mercury (mm/Hg)
• Diastolic lower than 80 mm/Hg

These numbers are usually written as a ratio with systolic first, such as 120/80.

For cholesterol, the ADA recommends:

• LDL, or “bad,” cholesterol less than 100 milligrams per deciliter (mg/dL)
• HDL, or “good,” cholesterol greater than 40 mg/dL for men and 50 mg/dL for women
• Triglycerides less than 150 mg/dL

Change Your Lifestyle, Change Your Heart Disease Risk

To lower your risk of heart disease and other diabetes complications, adopt a healthy lifestyle, says Kevin J. Goist, MD, assistant professor of clinical medicine at the Ohio State University Wexner Medical Center in Columbus. “Eating a proper diet, getting regular cardiovascular exercise, and losing or maintaining a healthy weight can help your heart. Plus, following these healthy habits can help control blood pressure, blood sugar, and cholesterol, all of which can lower your risk of heart disease,” Dr. Goist says.

In addition to following a healthy lifestyle, you should also take your medications as prescribed, check blood sugar regularly, and work with your doctor to make sure your blood pressure, cholesterol, and blood sugar are all under control, Goist says.

To get started, try these simple steps to protect your heart:

Exercise. Getting regular exercise can help you control your weight, as well as lower your blood pressure and cholesterol levels. In general, any form of cardiovascular exercise is great, Goist says. The AHA recommends 30 minutes of moderate-intensity exercise at least five days a week for a total of 150 minutes per week. Moderate-intensity exercise equals a brisk walk. If you exercise more vigorously, you can knock the time down to a total of 75 minutes per week. “If you have joint pain or osteoarthritis, you can go for lower impact exercises, such as water aerobics, swimming, bicycling, or the elliptical machine,” Goist says.

Cut out sugary drinks. Consider soda a double whammy: Research links sugary drinksto type 2 diabetes and an increased risk of heart disease. People who drink soda are 22 percent more likely to develop type 2 diabetes, according to a study published in April 2013 in the journal Diabetologia. And a 2012 study published in the journal Circulation that looked at 40,000 men over 40 years found those with the highest intake of sugary drinks were 20 percent more likely to suffer a heart attack or die from a heart attack than men who rarely drank sugary drinks.

Zonszein says to watch juice consumption as well. “Eating two servings of fruit a day is very healthy,” he says. “But if you have those fruits in the form of juice, you will absorb a lot more of the sugar than if you eat the whole fruit.”

Watch the salt. Although salt (sodium) doesn’t affect blood sugar levels, a high intake of salt may be linked with higher blood pressure. The ADA recommends people with diabetes consume less than 2,300 milligrams of sodium a day. If you have high blood pressure, your doctor will likely recommend you have even less salt per day. You can cut back on your salt intake by choosing fresh, whole foods over processed foods and using herbs and spices rather than salt to season your food.

If you’re wondering when to start new lifestyle habits, there’s no better time than now. “As soon as you are diagnosed with diabetes, it’s good to start making these changes,” Zonszein says. “You’ll have a much better chance of preventing a heart attack or stroke.” Your doctor can help answer questions specific to your own health and help you get started on a healthier path.