Diabetes and heart disease: risks, prevention and warning signs

Many people think of diabetes as a blood sugar problem only. But diabetes also affects the heart and blood vessels, and protecting them is a big part of care. This article explains what the NIDDK and NHS say about the link and about steps that help.

How diabetes affects the heart

The NIDDK explains that high blood glucose can damage blood vessels and the nerves that control the heart and blood vessels, which can lead to heart disease over time. It says adults with diabetes are nearly twice as likely as adults without diabetes to have heart disease or stroke. The NHS lists damage that can lead to coronary heart disease and stroke among the long-term complications of type 2 diabetes.

Other things that raise the risk

The NIDDK lists these added risk factors:

• Being male
• Smoking, which narrows blood vessels
• High blood pressure
• Abnormal cholesterol, including high LDL and high triglycerides
• Extra belly fat, with a waist over 40 inches for men or 35 inches for women
• Chronic kidney disease
• A family history of an early heart attack, such as before age 50

The ABCs of prevention

The NIDDK describes the "ABCs" as a way of remembering what to track:

• A is for A1C. Many people aim for below 7%, but your target may differ, so ask your care team.
• B is for blood pressure. Most people with diabetes aim for below 140/90 mm Hg, according to the NIDDK. Its managing diabetes page says some people may have a lower goal.
• C is for cholesterol. Ask your team about your numbers. The NIDDK says adults over 40 may need a statin, and some people with very high LDL may need one earlier.
• Stopping smoking matters too. The NIDDK includes e-cigarettes in this advice.

Alongside these, the NIDDK suggests a healthy eating plan, being active, keeping a healthy weight, enough sleep and managing stress. It says a doctor may prescribe medicines such as statins, aspirin if appropriate, or certain diabetes medicines that lower the risk of a heart attack. Decisions about medicines are for you and your doctor.

Warning signs of a heart attack

The NIDDK lists these signs and says to call for emergency help right away:

• Chest pain or pressure lasting more than a few minutes, or that goes away and returns
• Pain or discomfort in the arms, shoulders, back, neck or jaw
• Shortness of breath
• Sweating or light-headedness
• Indigestion or nausea
• Unusual fatigue

The NIDDK says women may have different symptoms, such as nausea, vomiting or prolonged tiredness. It also says people with diabetes-related nerve damage may not feel chest pain, so other signs matter.

Warning signs of a stroke

The NIDDK lists these signs, which also need emergency help right away:

• Sudden weakness or numbness on one side of the body
• Sudden confusion or trouble speaking or understanding
• Sudden dizziness, loss of balance or trouble walking
• Sudden vision trouble in one or both eyes
• Sudden, severe headache

The NIDDK notes that getting to a hospital within an hour of a stroke can help prevent permanent damage.

Routine care that helps

The NHS says people with type 2 diabetes should have checks at least once a year that include weight, cholesterol, blood pressure and kidney checks. Attending all diabetes appointments is one of the main ways to lower the risk of complications. The NIDDK also suggests bringing your blood glucose log and ABC results to visits.

When to see a doctor

Ask your doctor about your A1C, blood pressure and cholesterol results and what your own targets should be. If you smoke, ask for help to stop.

Heart attack and stroke signs are emergencies. Do not wait to see whether they pass. In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your own doctor.