Diabetes is among the strongest risk factors for heart and vascular disease. It’s right up there with smoking and having high blood pressure or high cholesterol. Having diabetes means you have too much sugar (also called glucose) in your blood. It can affect the way your heart works, and harm blood vessels. For example, the lining of the blood vessels may become thicker, which can impair blood flow. Many people have poor blood flow in their legs and feet, which can lead to numbness and weakness. Diabetes can damage other organs as well, including the kidneys.
Diabetes and heart disease share many of the same risk factors, such as having high cholesterol, being overweight, not exercising and smoking.
The Diabetes-Heart Disease Connection
- Most people with diabetes also have other risk factors for heart disease and stroke that they must manage.
- Strict control of things such as weight, not smoking, and blood sugar is critical.
- People with diabetes are just as likely to have a heart attack as those who’ve already had one.
If you have diabetes, it doesn’t mean heart disease is bound to happen. In many cases, there are steps you can take to keep your diabetes in check and stay ahead of heart disease. But it’s not always easy. If you have or develop heart disease, then you will have to manage several conditions, which can seem daunting.
Things you can change to be healthier—your weight, food choices and level of physical activity—are called “modifiable risk factors.” Understanding these factors and working to improve them can help you feel more in control of your health. Below are some tips for managing diabetes while staying heart healthy.
1. Set clear goals for controlling your diabetes and keeping tabs on your health.
Work with your health care team to decide 1) what lifestyle changes you can reasonably make, 2) if medicine or insulin is needed, 3) what your ideal level of blood sugar (also called blood glucose) should be, and 4) how to keep your cholesterol and blood pressure within a healthy range.
Ask questions if you don’t understand your health care provider’s suggestions for managing your diabetes or other heart risk factors. Your provider might want you to keep track of certain health measures at home; for example, by using home glucose or blood pressure monitoring, taking your pulse, or stepping on a scale to record your weight.
2. Be sure all of your health care providers are on the same page.
If you have diabetes, you probably see a number of specialists, including an endocrinologist, eye and foot doctors, in addition to your primary care provider. Most people living with diabetes have other health problems that need to be managed as well. Each provider may order blood work and other tests. Ask that copies of test results and notes from health visits be available to all of your providers so that everyone is on the same page. They should be aware of your conditions, treatments, up-to-date list of medicine and your goals for care.
3. Check your blood sugar level regularly, based on your provider’s advice.
The higher your blood sugar level, the higher your risk of heart disease. You and your health care provider should decide on your target A1C level; it may depend on your health conditions and age. A1C gives an estimate of your blood sugar over the past two to three months. Also, make sure you know what to do if your blood sugar is too high or too low.
4. Lose weight if needed.
Shedding 10 to 20 pounds can make a big difference when it comes to lowering your blood sugar, cholesterol and/or blood pressure. Plus, as you lose weight, you likely will feel better and more able to stay active and make healthy food choices. Take the time to talk with your health care provider about what weight loss plan might help you safely lose weight and keep it off.
—Edward Hulten, MD, MPH, FACC, Walter Reed National Military Medical Center, Bethesda, Md.
5. Get moving.
Our bodies are meant to move. Regular exercise can prevent diabetes and help control it. When you exercise, your blood glucose level goes down because your muscles use glucose.
The trick is to find things to do you enjoy and make them a habit. Sometimes, adding a social element can help keep it fun. Try signing up for a dance or swim class, or joining a running club or an online group that helps you check in and be accountable.
Getting 30 minutes of exercise at least five days a week often is advised. Talk with your health care provider about how to safely exercise more, especially before starting a new routine. Start slowly and commit to a certain number of days a week. If you can’t find 30-minute blocks of time, try to exercise for 10 minutes a few times a day. Remember, activities like cleaning the house and gardening also count. Exercise can lower blood sugar, and in some people, it can drop a lot, so keep your monitor and a snack available while exercising.
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6. Make healthy food choices.
Ahealthy diet, such as a plant-based or Mediterranean-style diet, can help control diabetes. It can also improve other heart disease risk factors such as obesity, cholesterol and blood pressure. Focus on eating nutritious foods that are low in fat and high in fiber, and aim to fill your plate with a colorful assortment of fruits and vegetables.
Foods high in carbohydrates can increase your blood sugar. Moderation is important when eating grains—and be sure to choose whole grains.
If you need advice, a nutritionist or dietitian can help.
7. Kick the habit.
If you smoke, quit. Diabetes and smoking can cause your blood vessels to tighten. If you need help, ask about local smoking cessation programs and other support services. While you’re at it, try to limit alcohol, too. Alcohol is a hidden source of sugar, and drinking too much can make other conditions worse or more likely.
8. Take all your medicine as prescribed.
Use reminders or a pillbox if needed. Tell your health care team if you have trouble taking your medicine (for example, remembering to take doses, side effects, concerns about cost). Make sure you understand why you are taking each medicine, how it works and what to do if you miss a dose. Ask your health care provider if you need to take an aspirin.
9. Be your own champion.
It can be hard to learn that you have diabetes, but it’s important to advocate for yourself and commit to lifestyle changes. You also need to take charge of your health. Uncontrolled diabetes can lead to eye and kidney issues. It also affects blood flow and sensations in your feet and legs, making you more prone to having sores that don’t heal and could become infected. If you have leg pain or numbness, tell your health care provider. You will need annual eye and foot exams, as well as routine blood work and other tests. Add reminders to your calendar so you don’t miss these health visits.
Many people with diabetes and heart disease also struggle with depression. Anxiety or depression can hinder your treatment and also may promote not-so-healthy choices. You might lose your steam to exercise or turn to fat-laden comfort foods or alcohol. Watch how you are feeling and seek help if needed. Stay involved in activities that make you happy, boost your mood and help you de-stress.
10. Find your team.
Whether it’s finding a walking buddy or someone to go to your health visits with you or just provide a listening ear, make sure to surround yourself with people who will support you and help you reach your goals.
Try to keep heart disease and stroke at bay by controlling:
- A1C (blood glucose)
- Blood pressure
In addition, always report any symptoms of chest pain, shortness of breath, vision changes, wounds that won’t heal, leg pain or numbness.
Resources to Help
For more information, visit CardioSmart’s type 2 diabetes condition center.
The American Heart Association also has a website called My Life Check that prompts you to check your cardiovascular risk and suggests steps you can take to live healthier.
The American Diabetes Association (www.diabetes.org) has a wealth of resources, too.
Last Reviewed: March 2019 | Medical Reviewers: John Bucheit, PharmD, BCACP, CDE; Deborah Croy, DNP, RN, ANP-BC, AACC
Originally Published: November 2016 | Medical Reviewers: Deborah S. Croy, DNP, RN, AACC; Edward A. Hulten, MD, FACC
CardioSmart Editor-in-Chief: Martha Gulati, MD, FACC