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Diabetes and Cardiovascular Disease: What’s the Link?

by Amy Scholten, MPH

Home | Health Information Center | Wellness Centers | Women's Health | Article

Risk of Cardiovascular Disease

Management of Diabetes

En Español

Cardiovascular disease (CVD) is a complication and cause of premature death among people with diabetes. Unfortunately, many people with diabetes do not understand the risk of cardiovascular disease or what they can do to help prevent it.

Diabetes is a disorder in which the body does not make insulin, does not make enough insulin, or does not properly use the insulin it makes (insulin resistance). Insulin helps metabolize glucose, the body's primary source of energy. Without insulin, glucose from food cannot enter cells. Glucose builds up in the blood and body tissues become starved for energy. Over time, persistent high blood glucose levels can damage the arteries, kidneys, eyes, nerves, and other tissues.

Risk of Cardiovascular Disease

Adults with diabetes are 2-4 times more likely to have CVD than people without diabetes. In people with diabetes, high blood glucose levels are associated with the development of atherosclerosis. This is a condition in which fatty deposits called plaque damage the lining of the arteries, causing them to narrow and harden. Atherosclerosis, a main cause of CVD, interferes with blood flow—ultimately leading to several manifestations of CVD including:

Coronary artery disease (CAD) and heart attack
Cerebrovascular disease and stroke
Peripheral artery disease (PAD) and claudication (pain with walking)

Why Is There a Risk?

People with type 2 diabetes often have an increased risk of CVD for the following reasons:

Platelets have an added tendency to clump together leading to clotting problems and poor blood flow
Higher rates of high blood pressure and obesity
Tendency for high cholesterol, particularly increased LDL or “bad” cholesterol, low levels of HDL or “good” cholesterol, and increased levels of triglycerides

Who Are the High-risk Groups?

Those with the highest risk for diabetes and its CVD complications include:

People with a family history of diabetes
Overweight and obese people, especially extra weight around the waist
Older people
Special populations
- African Americans
- Hispanic/Latino Americans
- Native Americans
- Asian Americans
- Pacific Islanders
People with diabetes who smoke double their risk of CVD

Management of Diabetes

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the management of 3 critical indicators is essential for reducing the risk of heart attacks and strokes in people with diabetes. It's as easy as ABC:

A— A1C test assesses chronic blood glucose by measuring a the effect on hemoglobin. The recommended goal for this test is a reading of less than 7%.
B— Blood pressure should be less than 140/80 mm Hg.
C—LDL cholesterol should be less than 100 mg/dL. Other cholesterol goals include:
- Triglycerides—should be under 150 mg/dL
- For men, HDL (good) cholesterol should be above 40 mg/dL, and for women it should be over 50 mg/dL

Individual goals may vary some. Talk to your doctor about which goals are right for you.

How Do You Lower the Risk?

People with diabetes can lower their risk of CVD with therapeutic lifestyle changes such as smoking cessation, weight management, and regular exercise. Drug therapy is also available to control some risk factors for CVD and prevent or treat the complications of diabetes.

People with diabetes can take the following steps to help reduce their risk of CVD:

Diligently control your blood glucose, cholesterol, and blood pressure with and without medications
Get involved in treatment decisions with your healthcare team
Be actively involved in the management of your disease
Get at least 30-60 minutes of physical activity on most days of the week
Set lifestyle goals
Become well-educated about diabetes and CVD
Eat a healthy diet that’s low in saturated fat and cholesterol and low in sodium
Eat more fiber
Ask about aspirin therapy for CVD prevention
If you smoke, quit. If you need help quitting, talk to your doctor

RESOURCES:

American Diabetes Association
http://www.diabetes.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Diabetes Association
http://www.diabetes.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References:

Cardiovascular disease & diabetes. American Heart Association website. Available at:
...(Click grey area to select URL)
Updated November 10, 2015. Accessed February 16, 2016.

Diabetes, heart disease, and stroke. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated August 2013. Accessed February 16, 2016.

Heart disease. American Diabetes Association website. Available at:
...(Click grey area to select URL)
Accessed February 16, 2016.

Hypertension treatments in patients with diabetes. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated April 21, 2015. Accessed February 16, 2016.

Lipid management in diabetes. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated May 13, 2015. Accessed February 16, 2016.

The link between diabetes and cardiovascular disease. US Department of Health and Human Services' National Diabetes Education Program website. Available at:
...(Click grey area to select URL)
Updated February 2007. Accessed February 16, 2016.

Last reviewed February 2016 by Michael Woods, MD
Last Updated: 2/16/2016

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