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When you have diabetes, you're at increased risk for heart disease — here's what you can do about it

By Brittany Doohan

Did you know that when you have diabetes, you’re at least twice as likely to have heart disease or a stroke as someone who doesn’t? People with diabetes also tend to develop these conditions earlier in life. Here's why, and what you can do to reduce your risk.

How Diabetes Affects Your Heart

The high blood glucose levels that are more common when you have diabetes can boost the fatty buildup in your blood vessels. These increased fatty deposits (called plaque) can reduce blood flow. This, in turn, boosts the chances that your blood vessels will clog and harden, a condition known as atherosclerosis.

Among these fatty substances is cholesterol. People with diabetes are more prone to unhealthy cholesterol levels, which in turn increases their risk for coronary heart disease (when plaque builds up in the arteries that surround the heart and supply it with blood; over time, this limits the flow of oxygen and other essential nutrients to your heart). 

If the plaque in a blood vessel ruptures, it can cause a blood clot to form, which can completely block the blood flow through one of these key arteries. This can cause serious health problems, including:

• Chest pain (angina). Angina can also cause pain in your arms, neck, jaw, shoulders or back. The pain may get worse when you exercise or exert yourself, and go away when you rest.

• Heart attack. A heart attack happens when the flow of oxygen-rich blood is cut off from a section of the heart. If the flow is cut off for too long, that section of the heart begins to die.

• Stroke. When the blood supply to the brain is blocked, a stroke can occur, which can cause serious brain damage. 

How to Prevent Heart Disease and Stroke

Preventing the first occurrence is key, as people with diabetes who’ve already had one heart attack run an even greater risk of having a second one.

• Manage your blood glucose. Make sure to have an A1C test at least twice a year. Work to stay at the target set by your doctor (for most people with diabetes, that's at or below 7). Sugar Sense (for Android and iOS) can give you an estimated A1C value to help you stay on track between doctor visits.

• Keep your blood pressure in range. Have your blood pressure checked every time you see your provider. For most people with diabetes, your target reading should be below 140/80.

• Monitor your cholesterol levels by getting tested at least once a year. The targets for most people with diabetes are:

• LDL (“bad”) cholesterol: below 100
• HDL (“good”) cholesterol: above 40 in men and above 50 in women
• Triglycerides (another type of fat in the blood): below 150

• Enjoy a heart-healthy diet.

• If you smoke, quit. 

• Talk to your doctor about aspirin. Taking a daily aspirin may reduce your risk of heart attack or stroke by interfering with the blood’s clotting action, but it isn’t beneficial for everyone.

Published on May 12, 2016. 

Brittany Doohan is a health and lifestyle writer and editor in San Francisco.