Your Heart and Diabetes

What is heart disease?

Heart disease includes several kinds of problems that affect your heart. "Cardiovascular disease" is similar but includes all types of heart disease, stroke, and blood vessel disease. The most common type of heart disease is coronary artery disease, which affects blood flow to the heart.

Coronary artery disease is caused by the buildup of plaque in blood vessels that supply oxygen and blood to the heart. Plaque is made of cholesterol deposits, which narrow the inside of arteries and decrease blood flow. This process is called atherosclerosis or hardening of the arteries. Decreased blood flow to the heart can cause a heart attack. Decreased blood flow to the brain can cause a stroke.

Hardening of the arteries can happen in the legs and feet too, which is called peripheral arterial disease, or PAD. PAD is often the first sign that a person with diabetes has cardiovascular disease.

How diabetes affects your heart

Over time, high blood sugar can damage blood vessels and the nerves that control your heart. People with diabetes are more likely to have other conditions that raise the risk for heart disease:

High blood pressure increases the force of blood through your arteries and can damage artery walls. Having both high blood pressure and diabetes can greatly increase your risk for heart disease.

Too much LDL ("bad") cholesterol in your bloodstream can form plaque on damaged artery walls.

Triglycerides are a type of fat in your blood. High triglycerides and low HDL ("good") cholesterol or high LDL cholesterol contributes to hardening of the arteries.

These factors can also raise your risk for heart disease:

• Smoking
• Being overweight or having obesity
• Not getting enough physical activity
• Eating a diet high in saturated fat, trans fat, cholesterol, and salt
• Drinking too much alcohol

People with diabetes are also more likely to have heart failure, which means your heart can't pump blood well. This can lead to swelling in your legs and fluid building up in your lungs, making it hard to breathe. Heart failure tends to get worse over time. However, early diagnosis and treatment can help relieve symptoms and stop or delay the condition getting worse.

Testing for heart disease

Your blood pressure, cholesterol levels, and weight helps your doctor understand your overall risk for heart disease. Your doctor may also recommend other tests to check your heart health:

An electrocardiogram (ECG or EKG) measures your heart's electrical activity. Your heartbeat is the result of an electrical impulse traveling through your heart.

An echocardiogram (echo) examines how thick your heart muscle is and how well your heart pumps.

An exercise stress test (treadmill test) shows how well your heart functions when it's working hard.

Take care of your heart

These lifestyle habits can help lower your risk for heart disease or keep it from getting worse:

Follow a healthy diet

• Eat more fresh fruits and vegetables, lean protein, and whole grains.
• Eat fewer processed foods (such as chips, sweets, and fast food).
• Drink more water, fewer sugary drinks, and less alcohol.

Aim for a healthy weight

If you're overweight, losing even a modest amount of weight can lower your triglycerides and blood sugar.

Get active

Being physically active makes your body more sensitive to insulin, which helps manage your diabetes. Physical activity also helps manage blood sugar levels and lowers your risk of heart disease.

Manage your ABCs

• A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months. Aim to stay in your target range as much as possible.
• B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
• C: Manage your cholesterol levels.
• s: Stop smoking or don't start.

Manage stress

Stress can raise your blood pressure and lead to unhealthy behaviors, such as drinking too much alcohol or overeating. Try these ideas instead:

• Visit a mental health counselor
• Try meditation or deep breathing
• Get some physical activity
• Get support from friends and family

Your doctor may prescribe medicines to help keep your blood sugar, blood pressure, cholesterol, and triglycerides close to your target levels.

See your diabetes educator

Work with a diabetes care and education specialist for help avoiding health complications such as heart disease. You'll get support and solutions and hear about the latest advances in managing diabetes. Be sure to ask your doctor for a referral if you don't already have a diabetes educator.