There is a clear relationship between diabetes and heart disease. According to the American Heart Association heart disease and stroke are the number one causes of death and disability among people with type 2 diabetes. The good news is diabetes is a preventable and controllable disease. Understanding how diabetes affects your heart health is the first step in taking action to reduce your risk of cardiovascular complications.

Diabetes 101

The two main types of diabetes are type 1 and type 2. Type 1 diabetes occurs when the pancreas makes little or no insulin. Without insulin the body is unable to take glucose (blood sugar) it gets from food into cells to fuel the body. It is sometimes referred to as “juvenile diabetes” because it is often diagnosed in children or young adults. People with type 1 diabetes must take daily injections of insulin to survive. Type 2 diabetes is the most common form of diabetes. It develops while the pancreas is still producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. Gradually insulin production decreases and blood sugar levels begin to rise causing diabetes to develop. Historically, type 2 diabetes is diagnosed in middle aged adults however it is now occurring in adolescents and young adults at a disturbing rate due in part to the rising obesity epidemic. The actual cause of type 2 diabetes is unclear, however, both genetics and lifestyle or environmental factors are believed to be key players in its development. Risk factors for type 2 diabetes include people with impaired glucose tolerance and impaired fasting glucose, obesity (especially if weight is centered around the stomach often called central obesity), age (over 45 years), physical inactivity, high blood pressure, abnormal cholesterol levels, and family history of diabetes or cardiovascular disease. Additional risk factors for women include diabetes during pregnancy, giving birth to at least one baby weighing more than 9lbs, and polycystic ovary disease (PCOS).

Diabetic Heart Disease

The term “diabetic heart disease” (DHD) refers to heart disease that develops in people who have diabetes. Type 1 or type 2 diabetics can develop DHD. Research has shown when combined with other risk factors such as high blood pressure, high blood cholesterol, lack of physical activity, obesity, and smoking harmful physical changes occur in the heart. These changes can damage the heart’s structure and function. More importantly, in the early stages of diabetes, insulin resistance is related to fatty build-up in the arteries of the heart (atherosclerosis) and blood vessel damage even before diabetes is diagnosed.

Take Action

If you are a diabetic or if someone close to you is, taking action now can prevent or delay heart disease. Adopting a healthy lifestyle should be part of a lifelong approach. Small yet powerful changes can help control multiple risk factors. For example, daily physical activity has been shown to lower your blood pressure, control your sugar level, reduce stress, and help control weight. Other important actions steps include following a healthy diet, maintaining a healthy weight and waist circumference, and quitting smoking. Following the treatment plan your doctor recommends for you is crucial. Diabetics need good blood sugar control. Ask your doctor about ways to best control your blood sugar. Talk with him/her if you’re having trouble taking your medications or if you are having any side effects. Take time to discuss your risk of diabetic heart disease. Know your other important health numbers like cholesterol and blood pressure. Utilize other members of your health care team. See a dietician for help learning about or following a healthy diet that helps control blood sugar. Talk with your pharmacist to learn more about your medications and how they work. Take action now for a healthier heart and healthier life.

ConditionsDiabetes-Heart Disease Connection
High Blood Pressure Studies show a positive link between high blood pressure and insulin resistance (or the body’s inability to use glucose effectively). Elevated blood sugar can also slowly damage blood vessels in the kidneys leading to higher blood pressure levels.
High Blood Cholesterol Diabetes tends to lower "good" cholesterol levels and raise triglyceride and "bad" cholesterol levels, which increases the risk for heart disease and stroke.
Lack of Physical Activity Lack of physical activity can worsen other risk factors for heart disease such as high cholesterol, high blood pressure, diabetes, and overweight or obesity.
Obesity Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Obesity and insulin resistance have also been linked with other risk factors, including high blood pressure and high cholesterol.
Smoking Smoking raises blood glucose levels. Smoking also aggravates other risk factors such as increasing cholesterol levels and raising blood pressure. Smoking can also reduce the amount of vital oxygen that reaches the heart muscle.



- American Heart Association
- American Heart Association
- The American College of Cardiology
- The National Heart, Lung, and Blood Institute/National Institutes of Health
- The National Heart, Lung, and Blood Institute/National Institutes of Health
- About High Blood Pressure