Diabetes and Heart Disease Risks You Shouldn’t Ignore

By Athena Philis-Tsimikas, M.D.

Published Oct 1, 2014

Let’s have a heart-to-heart talk about diabetes and cardiovascular health. If you have diabetes, you have an increased risk of serious problems such as heart disease, heart failure or stroke — at least twice the risk of someone without diabetes. Moreover, you are also more likely to develop these problems at a younger than average age, and have more serious heart attacks.
According to the American Diabetes Association, two out of three people with diabetes die from heart disease or stroke.
Here’s one reason why: Diabetes is characterized by chronically high blood glucose levels. Over time, these elevated levels can cause fatty deposits called plaque to build up along the walls of your blood vessels, a condition known as coronary heart disease. As the plaque becomes thicker, the blood vessels become harder and narrower, making it difficult for blood to flow freely to the heart and damaging the heart muscle.
Diabetes can also raise the risk of blood clots, which can cause stroke. Stroke happens when the flow of blood to the brain is blocked, depriving brain cells of the oxygen they need to survive.
Diabetes also makes people more vulnerable to heart failure, which impedes the heart’s ability to pump blood efficiently to the rest of the body and can cause shortness of breath and an irregular heartbeat.

More Risk Factors: High Cholesterol, High Blood Pressure, Obesity

In addition to diabetes itself, people with diabetes are more likely to have other health problems that raise the risk of cardiovascular problems, such as obesity, high blood pressure, or unhealthy cholesterol levels. Obesity and high blood pressure force your heart to work harder than normal to pump blood through your body, which increases your chances of having a heart attack or stroke.
Often, people with diabetes have too much “bad” LDL cholesterol and not enough “good” HDL cholesterol, as well as high levels of blood fats called triglycerides. In people with diabetes, this combination is known as diabetic dyslipidemia and can contribute to coronary heart disease and stroke.
Estrogen helps protect women from heart disease, so women who have not gone through menopause have a lower risk of heart disease than men of the same age. However, diabetes removes this protection — women who have diabetes have an increased risk regardless of age.
You don’t necessarily need to have full-blown diabetes to have a higher risk of cardiovascular problems. Even having prediabetes — blood glucose levels that are higher than normal, but not yet high enough to qualify as diabetes — can raise your risk.

Take These Steps Today to Protect Your Heart

Having diabetes doesn’t mean a heart attack or stroke is inevitable. You can reduce your risk by taking the same preventive actions recommended for anyone who wants to keep their heart healthy. Eat a heart-smart diet that is high in soluble fiber and low in saturated fat and trans fats. Get at least 30 minutes of cardiovascular exercise most days of the week, and maintain a healthy weight. In addition to benefiting your heart, losing weight can prevent or delay the onset of type 2 diabetes, and may even reverse it.
Talk to your physician or diabetes educator about specific actions you can take to help protect your heart and reduce your risk.
Athena Philis-Tsimikas, M.D., is an endocrinologist and the Corporate Vice President for the Scripps Whittier Diabetes Institute at Scripps Health in San Diego.