Diabetic Heart Disease: Why Diabetes Raises Heart Risk, and How to Lower It

Diabetes in brief

In diabetes, your blood glucose (blood sugar) is too high. Glucose comes from food, and your cells need it for energy. A hormone, insulin, helps it into your cells.

• In type 1 diabetes, your body doesn't make insulin.
• In type 2, it doesn't make or use insulin well.

Without enough insulin, glucose builds up in the blood.

What diabetic heart disease is

It's heart disease in people with diabetes. With diabetes you are much more likely to get heart disease or have a stroke, and it may start at a younger age. Over time, high blood sugar can damage the blood vessels and nerves of the heart, raising the chance of:

• Coronary artery disease (CAD) — sticky plaque slowly builds up in the arteries that feed the heart muscle.
• Heart failure — the heart can't pump enough oxygen-rich blood for the body's needs.
• Cardiomyopathy — diseases that can make the heart muscle thick or stiff.

Who is at higher risk

Diabetes itself is a serious risk, and it makes other risks more likely:

• high blood pressure;
• high LDL ("bad") cholesterol;
• high triglycerides (a blood fat) with low HDL ("good") cholesterol.

Your risk also rises if you:

• are male;
• smoke;
• have obesity;
• carry too much belly fat, even at a healthy weight — a waist over 40 inches for men, 35 inches for women;
• have a family history of heart disease;
• have chronic kidney disease.

Symptoms

Early heart disease usually has none. As it worsens, symptoms depend on the type, and may include:

• shortness of breath;
• fatigue;
• dizziness or fainting;
• arrhythmia, a problem with the rate or rhythm of the heartbeat;
• swollen feet and ankles;
• chest pain.

People with diabetes may feel no chest pain, because diabetes can damage the heart's nerves. If you have any symptom that could be heart disease, talk with your health care provider.

Diagnosis

Your provider will ask about your symptoms, other health conditions and family history, examine you, and likely run tests of your personal risk: blood tests for cholesterol, triglycerides and blood sugar, a blood-pressure check, and heart tests if needed. Depending on your risk, you may be sent to a cardiologist, a heart specialist. Treatment depends on the type of heart disease.

Prevention

With your provider, you may be able to prevent heart disease or slow it:

• control your blood sugar;
• manage other conditions that raise your risk;
• take the medicines prescribed;
• build heart-healthy habits into daily life;
• follow a healthy eating plan for diabetes.

Sources

Based on "Diabetic Heart Disease," MedlinePlus, National Library of Medicine, drawing on the National Institute of Diabetes and Digestive and Kidney Diseases (NIH); a work of the United States government in the public domain.