What Does Diabetes Do to Your Heart Disease Risk?

Medically Reviewed by Michael Dansinger, MD on July 23, 2021

Many people with diabetes also have heart disease. When you do things to take care of your diabetes, like manage your blood sugar, exercise, and eat a healthy diet, that's also good for your heart.

In people under age 75, a quarter of deaths from heart disease and stroke could be prevented. It’s a really good idea to be proactive when it comes to your heart health when you have diabetes. That’s because your risk of stroke or heart attack is double that of someone without it.

It's important to understand your risk and how you can lower it.

Besides diabetes, do you also have:

  • A waist that's larger than 35 inches in women or 40 inches in men?
  • Low levels of "good" ( HDL) cholesterol?
  • High levels of "bad" (LDL) cholesterol or triglycerides (another type of fat in the blood)?
  • High blood pressure?
  • Even borderline elevated at 130/85

If you're not sure, your doctor can check all those numbers for you.

Also, do you:

Your doctor needs that information to work with you on a plan for better heart health.

Types of Heart Disease

People with diabetes are at risk for:

Coronary artery disease. Your coronary arteries are in your heart. Fatty deposits, called plaques, can narrow them. If plaque suddenly breaks, it can cause a heart attack. Exercise, eating a healthy diet, and not smoking are musts. It could be from coronary artery disease or from the diabetes. It can be dangerous and fatal, so aggressive management and follow up is essential.

Congestive heart failure. This is an ongoing condition in which the heart loses the ability to pump blood effectively. The main symptoms are shortness of breath when you're moving and leg swelling.

Many people have both conditions.

Take Action

Quit smoking. Smoking is hard on your heart, not just your lungs. Smoking cigarettes makes a person two to four times more likely to have heart disease and twice as likely to have a stroke. If you smoke, it's time to quit. Set a date and talk to your doctor. If you've tried to quit before, it's not too late. Many people try several times before they kick the habit for good. Today, there are more former smokers than current smokers.

Counseling (individual, group, and telephone), therapies that focus on problem-solving, and program treatments via phone all work in helping people quit. Nicotine patches, inhalers, and prescribed drugs also work. Counseling and drugs together work better than either by itself.

Get moving. Nearly everyone with diabetes can benefit from getting more exercise. It's good for your heart, lowers your blood pressure, burns calories, and helps control your blood sugar and cholesterol levels. Together, this adds up to strong protection. 

Even brisk walking at least 5 days a week counts, so you don't need a gym. If 30 minutes seems like too much, start with less and build up slowly. The key is to walk at a brisk pace and to increase how long and how often you move.  

Track your steps every day. You can use an app on your smartphone or buy a pedometer (step counter). Seeing how many steps you take a day can motivate you to be more active.  

If you're not active now, let your doctor know you want to get started. They can let you know what's safe for you to do.

Choose heart-healthy fats. The kinds of fats in the foods you eat affect the cholesterol in your bloodstream. Skip processed snacks and sweets, fried foods, whole milk and cheese, solid fats like butter, and fatty red meats. They have saturated and trans fats, which are not good for your heart. Instead, pick unsaturated fats. They come mainly from plants, like vegetable oils, nuts, and seeds. They are thought of as "good" fats because they improve your cholesterol levels, which is good for your heart. 

Omega-3 fats are also heart-healthy. They help keep your arteries from clogging. So try to eat non-fried fish at least twice a week. Pick healthy fatty fishes like salmon, albacore tuna, sardines, rainbow trout, and mackerel to boost your omega-3 healthy fats. Soybean products, walnuts, flaxseed, and canola oil are other good sources of omega-3s.

For the best heart benefits, go out with the "bad" fats and add "good" fats at the same time. Instead of a burger or ribs (which have unhealthy saturated fats), order grilled salmon or trout. Instead of using butter when cooking, use vegetable, olive, or canola oil. Instead of cheese on your sandwich, try a little avocado on it instead.

Fill up on whole grains, fruits, and vegetables. Whole grains, fruits, and vegetables are high in fiber and low in calories. That makes them ideal foods for staying at a healthy weight. A 2009 study found that people cut their risk of heart disease by 81% and their risk of stroke by 50% if they:

  • Kept their weight down
  • Exercised 3.5 hours or more a week
  • Didn't smoke
  • Ate whole grains, fruits, and vegetables

And a large 2011 study showed that Swedish women who ate a lot of antioxidant-rich fruits and vegetables cut their risk of stroke by 17%. Citrus fruits and dark orange, red, yellow, and green vegetables and fruits are good sources of antioxidants. Set a goal of filling half of your plate with fruit and vegetables.

Stay at a healthy weight. Losing extra weight and keeping pounds off isn’t easy. But research shows that staying at a healthy weight lowers your risk of heart disease and stroke. Don’t lose heart if it takes time to drop the pounds. Even if you don’t lose weight, you'll cut your risk of heart disease and stroke by exercising and choosing healthy foods.

Ask about medicine.Some people with diabetes need to take medicine to lower their blood pressure or improve their cholesterol levels. Your doctor may recommend that you take a daily low-dose aspirin to protect against heart disease.

Be sure to keep up with your medical care. Taking care of your diabetes lowers your chances of heart disease and stroke. If you keep your blood pressure, cholesterol, and A1c (which is your average blood glucose over the past 2 or 3 months) levels in check, you're on a good path. But to do this, you need to know your numbers. Get checkups often that include blood tests and a physical exam.

Go to all your appointments and let your doctor know how you're doing.  Together, you can work toward a healthier heart.

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