Your Diabetes and Heart Health Treatment Plan

Type 2 diabetes doesn't only affect your kidneys, eyes, and nerves. Untreated high blood sugar, or glucose, also damages blood vessels and raises your risk for a heart disease, including heart failure, heart attacks, and stroke.

Diabetes is one of the biggest risks for heart disease, on par with smoking and high cholesterol. And it can start to damage your heart fairly early on.

The two conditions share many of the same risk factors, including:

  • High blood pressure
  • High cholesterol and triglycerides
  • Extra weight
  • Smoking

The longer you live with type 2 diabetes, the more your risk of heart disease goes up. But whether you’re newly diagnosed or you’ve had it for years, you and your doctor can make a plan to manage your diabetes and help keep your heart healthy.

Diabetes Medicines and Your Heart

Many types of medicines can treat type 2 diabetes. All of them can help lower your blood sugar, but some are better for your heart, while others may be harmful.

One type, called SGLT2 inhibitors, helps your kidneys remove extra sugar in your urine. It also lowers your risk for heart failure and death from heart disease.    

Another kind, called GLP-1 receptor agonists, makes your pancreas release more insulin to keep your blood sugar levels under better control. They also lower your risk of a heart attack, stroke, and of dying from heart disease.

Studies are testing whether other diabetes drugs, like metformin, might also protect against heart disease.

Some of the drugs that lower blood sugar to treat diabetes can actually raise your heart risks. These include pioglitazone (Actos) and rosiglitazone (Avandia), insulin, and a group of drugs called sulfonylureas.

If your doctor recommends a medicine for you, ask how it may affect your heart health.

Treat Other Health Conditions

Managing these conditions, if you have them, can help you avoid heart disease.

High blood pressure. Blood pressure is the force of blood moving through your arteries. When it stays high for a long time, it can damage your blood vessels and heart. Along with a low-fat, low-salt diet and exercise, medicines can help bring your blood pressure back into a normal range.

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High cholesterol and triglycerides. Cholesterol and triglycerides, a type of fat in your blood, can damage blood vessels and cause plaque to build up. LDL, or “bad,” cholesterol is the kind that builds up in arteries and slows blood flow. HDL cholesterol is the healthy kind that's linked to a lower risk for heart disease. People with type 2 diabetes often have low HDL and high triglycerides, which lead to high LDL.

A diet low in saturated and trans fats and extra carbs, weight loss, and regular exercise can help lower LDL and triglycerides and raise HDL cholesterol. If these lifestyle changes alone don't budge your numbers, your doctor might prescribe a statin or other cholesterol-lowering medicine.

Overweight. Carrying a lot of extra weight, especially around your middle, can make your diabetes harder to control. Fat cells don't respond as well to the hormone insulin, which moves sugar out of your bloodstream.

People who are overweight are more likely to have other heart risks, like high cholesterol and high blood pressure. Plus, extra fat leads to inflammation that's harmful to the heart and rest of your body. The same diet and exercise plan you follow to control your blood sugar will also help you lose weight.

Smoking. Chemicals in tobacco smoke damage your blood vessels and put you at an even higher risk for heart disease. Smoking also makes your diabetes harder to control. Quitting can be hard, but medicines and other tools from your doctor will help you get off tobacco for good.

Other Medicines to Protect Your Heart

If you already have heart disease, your doctor might put you on one or more of these drugs to lower your risk for a heart attack or stroke:

  • Statins or other medicines to lower cholesterol
  • ACE inhibitors or other drugs to lower blood pressure
  • Low-dose aspirin

Check in With Your Doctor

You'll see your doctor about once every 3 to 6 months to check how well you're managing your diabetes. You may need to visit more often if your blood sugar isn't under control.

Those visits should also include a review of your heart health, especially if you already have heart disease. Ask your doctor how often you should have your blood pressure, cholesterol, and triglyceride levels checked. You may need to change your diabetes or heart disease treatment plan if your numbers aren't in a healthy range.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 24, 2019

Sources

SOURCES:

American College of Cardiology: "The Role of Newer Anti-Diabetic Drugs in Cardiovascular Disease," "Type 2 Diabetes and Cardiovascular Risk Toolkit."

American Heart Association: "Cardiovascular Disease and Diabetes," "Cholesterol Abnormalities and Diabetes," "Prevention and Treatment of High Cholesterol."

CDC: "About High Blood Pressure," "Controlling High Blood Pressure," "Smoking and Diabetes."

Circulation: "Empagliflozin reduced mortality and hospitalization for heart failure across the spectrum of cardiovascular risk in the EMPA-REG OUTCOME Trial," "Repurposing metformin for cardiovascular disease."

Circulation Research: "Obesity, diabetes, and cardiovascular disease."

Cleveland Clinic: "Working With Your Diabetes Health Care Team."

Diatribe.org: "Victoza Approved to Reduce Risk of Heart Attack, Stroke, and Heart-Related Death."

JAMA Network Open: "Association of Second-line Antidiabetic Medications with Cardiovascular Events Among Insured Adults With Type 2 Diabetes."

Johns Hopkins Medicine: "Diabetes Medications That Treat Heart Disease, Too."

Mayo Clinic: "Diabetes Symptoms & Causes."

National Institute of Diabetes and Digestive and Kidney Diseases: "Diabetes, Heart Disease & Stroke."

UpToDate: “Glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes mellitus,” “Sodium-glucose co-transporter 2 inhibitors for the treatment of hyperglycemia in type 2 diabetes mellitus.”

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