Aaron contacted The Diabetes Council with some questions related to diabetes and heart disease.
Aaron is 57 years old. He has had Type 2 diabetes for 12 years. Aaron visited his doctor related to swelling in his ankles and feet, shortness of breath, and weight gain.
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After some tests, the doctor informed him that on top of his Type 2 diabetes, he now has congestive heart failure. He was now wondering why did he have heart disease now and was it because of his diabetes?
In order to help Aaron and other people with diabetes understand the connection between diabetes and heart disease and how to prevent it, we decided to look into the specific link between the two diseases.
What is the connection between diabetes and heart disease?
According to the American Heart Association, there exist a relationship between cardiovascular disease and diabetes: 68% percent of people with diabetes who are aged 65 and older die from heart disease and 16% die of a stroke.
People with diabetes are more likely to die from a heart disease than those without diabetes.
The National Institute of Health states the following for people with diabetes:
- They have additional causes of heart disease
- They are at higher risk of heart disease than those who do not have diabetes
- They may develop heart disease at a younger age
Risk assessment must take into account the major risk factors (cigarette smoking, elevated blood pressure, abnormal serum lipids and lipoproteins, and hyperglycemia) and predisposing risk factors (excess body weight and abdominal obesity, physical inactivity, and family history of CVD). Identification of risk factors is a major first step for developing a plan for risk reduction in persons with diabetes. – Scott M. Grundy et al, Diabetes and Cardiovascular Disease
In two words, the connection between diabetes and heart disease can be summed up related to “high glucose.” It has often been said that diabetes is not the problem, and that it is the high glucose in the blood that is the problem. Indeed it is high glucose levels that cause more problems as the condition wreaks havoc throughout bodily organs. Blood vessels of all types and sizes get damaged from high glucose. From the tiniest blood vessel in the tips of your toes to the largest blood vessels in your heart, high blood glucose provides the connection between heart disease and diabetes.
In addition, high glucose over time also causes damage to nerves throughout the body. Compare it to a car that someone has put oil into the gas tank instead of gasoline. The thick viscosity of the oil sticks to the side of the pipes, and clogs up the pistons in the engine. The engine is then compromised from the thick oil running through it. It can’t run like that, and it just gives out.
It’s the same with the sugary sweet, thick blood from high glucose. The blood is sticky, and it sticks to the sides of veins and arteries, causing atherosclerosis or hardening of the arteries. No blood vessel is left unscathed. The blood vessels in the tips of your fingers and toes are affected, as are the larger vessels throughout the body, and vessels within organs, including the heart. Eventually, this causes problems with the organs, and they are compromised. The end result is organ and circulatory problems that can lead to organ failure, and death.
I suggest reading the following:
- Never Lose Hope in the Face of Defeat
- Exercise Activities That Every Person with Diabetes Should Do
- Diabetes And Renal Failure: Everything You Need To Know
- Can An Exercise Physiologist Help With Your Diabetes?
- If I Have Diabetes, Will I Have to Stop Eating Sugar?
If you have uncontrolled diabetes for a long time, you are twice as likely to develop heart disease at a younger age. In adults with diabetes, heart disease is the most common cause of death. People with diabetes often have comorbidities that increase their risk of heart disease and stroke. These comorbidities are high blood pressure and high cholesterol, which often go hand in hand with diabetes. Therefore, it is important to manage blood glucose if you have diabetes, along with high blood pressure and cholesterol as well to prevent heart disease.
Does diabetes put me at an increased risk of heart disease or stroke?
As previously mentioned, it is not so much the diabetes as it is high blood glucose excursions. People with diabetes are twice as likely to have heart disease as their peers without diabetes. Also, when you have diabetes for a number of years you are more at risk for heart disease. Diabetes is definitely a risk factor for heart disease. Once you are diagnosed, you do not have to accept the fate that you will one day have heart disease or have a stroke. The way that you manage your diabetes is the most important factor in determining whether or not you will have heart disease or a stroke down the road.
If blood sugars remain elevated over time, it affects your body’s blood vessels, including all veins and arteries in your body that go to all organs in your body. Therefore, if you keep your diabetes well-managed, you can avoid heart disease and stroke as related complications. However, if you have had diabetes for a long time, and you have had trouble managing your diabetes and keeping your A1C, cholesterol numbers, and blood glucose in target, then you will be more at risk for heart disease or stroke.
In order to lower your chances of a heart attack, the NIDDK recommends that patients manage their diabetes ABCs:
- A for the A1C test – The higher your numbers, the higher your glucose levels are. High levels of glucose in the blood can bring harm to your heart and blood vessels (along with your kidneys and eyes).
- B for Blood pressure – Your blood pressure, as a person with diabetes, must be below 140/90 mm Hg. Check with your doctor what yours should be at.
- C for Cholesterol – As this article mentions, too much of bad cholesterol can be the cause of your heart attack or stroke. Check with your health care team as to what your appropriate cholesterol numbers should look like.
- S for Smoking – we cannot stress enough how injurious smoking is to health overall but even more so for people with diabetes. Smoking, along with having diabetes, narrow blood vessels which forces your heart to work harder.
By Elisabeth Almekinder RN, BA, CDE