The Connection Between Diabetes & Heart Health: What You Need to Know

Reviewed By: Rebecca Anderson, FNP-BC

Did you know that heart disease is the leading cause of death in America [1]? Heart health conditions, including heart disease, are a persistent and prevalent issue that should be addressed as early as possible to reduce dangerous complications. There are many causes of heart disease and other heart conditions, but today we are focusing on diabetes, also known as a “heart disease risk multiplier.” It’s true—having diabetes makes you 2 times more likely to suffer from heart disease [2], which is why it requires immediate attention and treatment. In this blog post, we’ll explain the connection between diabetes and heart health, as well as share some practical tips for prevention and keeping your health in check.

How Diabetes Impacts Heart Health

Diabetes occurs when your blood sugar (glucose) levels are too high and your body doesn’t make enough, or any, insulin [3]. Insulin helps your body process blood sugar in your cells and use it for energy. However, when your body doesn’t make enough, or any, insulin, glucose stays in your blood at elevated levels. This can lead to many complications, including concerning symptoms in the kidneys, eyes, nerves, and heart.

Having high blood sugar levels over a prolonged period can lead to inflammation, which can damage tissues, including blood vessels [4]. Type 2 diabetes, in particular, is highly associated with chronic inflammation, which can lead to plaque buildup in the arteries. Over time, the plaque clogging the arteries can harden, reducing blood flow to the heart and other vital organs.

These issues can result in serious heart health issues, like heart disease [5]. They can also lead to other heart complications, like high blood pressure (hypertension), stroke, and heart attack [6].

Risk Factors That Overlap Between Diabetes and Heart Disease

Many health issues and factors overlap among individuals who suffer from both diabetes and heart disease. Many individuals experience “metabolic syndrome,” which describes a grouping of 3 or more conditions that raise the risk of heart issues [7]. These conditions include obesity, high blood pressure, impaired blood sugar, high triglycerides in the blood, and low HDL (“good”) cholesterol [7]. Although genetics certainly plays a role in these health issues, lifestyle and behavioral choices also contribute to raising the risk for diabetes and heart disease. A sedentary lifestyle, or a lifestyle where most of your time is spent sitting, is associated with a higher risk of heart disease and type 2 diabetes [8]. Likewise, smoking cigarettes makes heart conditions more likely to occur among individuals with diabetes and/or high blood pressure [9]. Finally, factors like poor stress management are linked to high blood pressure and obesity, which are associated with heart disease and diabetes [10].

Symptoms to Watch For: When Diabetes Affects Your Heart

If you have diabetes, it’s essential to be aware of the warning signs that your heart health may also be affected. If you experience the following symptoms, you may have “diabetic heart disease,” which is when a person has both diabetes and heart disease [11]:

Fatigue
Chest pain
Shortness of breath
Swelling, especially of the feet or ankles
Dizziness or fainting
Fast or slow heartbeat

Diabetes can also lead to nerve damage (neuropathy) which is a complication of diabetes. While this most often affects the feet and legs, in some cases it involves the nerves that control the heart and blood vessels. This type of autonomic neuropathy can sometimes blunt warning signs of heart problems — for example, a person may have a “silent” heart attack without the typical chest pain. [12]

Heart-Healthy Habits For People With Diabetes

Manage Blood Sugar Consistently

Because high blood sugar is associated with poor heart health, managing your blood sugar and measuring it regularly can help you decrease your risk. Individuals without diabetes should have an A1C level below 5.7%, and individuals with diabetes should aim for an A1C of 7% or lower [13]. However, the right target can vary based on your age, overall health, and other medical conditions — so it’s always important to check with your doctor about what a good A1C goal is for you.

Eat for Both Blood Sugar and Heart Health

Diet is a crucial aspect of managing high blood sugar and heart conditions [14]. A heart-healthy diet for individuals with diabetes consists of fiber, healthy fats, whole grains, and non-starchy vegetables [15]. Some food options that fall into these categories include leafy greens, salmon, tuna, nuts, oatmeal, wheat bran, avocados, mushrooms, broccoli, and beans, just to name a few. You should also avoid excess carbohydrates and sodium [16]. Choosing “smart carbs,” like low-fat dairy products and whole grains, as well as reduced-sodium options, is best for your health. Remember to consult with your healthcare provider before making any drastic changes to your diet.

Move Daily to Strengthen the Heart

Exercise can strengthen heart health and support the management of diabetes [17]. This is because it can lower blood sugar and blood pressure, increase your metabolism, and improve your overall health and mood. Researchers recommend that individuals with heart disease and diabetes partake in a combination of aerobic exercises (such as walking and swimming) and resistance training (such as weightlifting) [18]. Work with your healthcare provider to create an exercise routine suited to your needs and abilities.

Control Blood Pressure and Cholesterol

Regularly monitoring your blood pressure and cholesterol levels can provide more insight into whether you are at risk for a heart health issue. Although most adults get their blood pressure and cholesterol checked once a year at their annual physical exam, individuals with heart disease or other heart health conditions will likely need theirs checked more often [19]. Speak with your doctor about how often you should monitor your blood pressure and cholesterol, and ask if any medications or lifestyle changes might help.

Stop Smoking (and Reduce Alcohol Intake)

Healthcare professionals highly recommend avoiding smoking and alcohol consumption if you have heart health conditions and/or diabetes. Smoking accelerates heart complications because it increases bad cholesterol and lowers good cholesterol, which raises the risk of heart disease [20]. Likewise, smoking causes inflammation, which weakens your body’s response to insulin and increases blood sugar levels [20].

Drinking alcohol heavily is associated with increased risk for high blood pressure, heart failure, and stroke [21]. Alcohol can initially raise blood glucose if the drink contains carbohydrates, but heavy drinking can also interfere with the liver’s ability to release glucose. When combined with certain diabetes medications, this may lead to dangerously low blood sugar, which can cause serious symptoms and complications.[22]. Try to cut back on smoking and drinking either entirely or as much as possible. If you are struggling to do so, reach out to a professional for support.

Sleep and Stress Matter More Than You Think

You may be surprised by how much of a difference healthy habits, like getting quality sleep and managing stress, can make in heart conditions and diabetes. According to experts, poor sleep quality increases the risk of cardiovascular disease, high blood pressure, high blood sugar, and obesity [23]. The effects of stress are comparable. Prolonged stress and the release of too much of the stress hormone called “cortisol” can lead to insulin resistance [24]. And with heart disease, some experts even list stress as one of the leading risk factors of this condition [25].

To improve your sleep quality and stress management, talk to your healthcare provider to create an action plan. They may recommend trying different coping mechanisms, practicing meditation, using sleep aids, decreasing caffeine intake, or seeking support from a specialist.

How to Talk to Your Doctor About Your Heart Risk

Some key questions you should ask during your next appointment include:

How often should my blood pressure and blood sugar be checked?
Are there any screening tests available to assess my health in these areas? (Some key tests to request include A1C, lipid panel, and blood pressure [26, 27])
What is my risk of developing heart conditions?
Are there any lifestyle changes I can make now to reduce this risk?

The Bottom Line: A Healthier Heart Starts with Blood Sugar Control

As you age, your health becomes increasingly important to monitor and care for. Diabetes and heart conditions are interconnected, and many symptoms overlap. This is why it’s essential to stay diligent in screening for both and to be aware of the warning signs that may already be present. Part of advocating for your health is taking small daily actions that contribute to long-term protection. At Greater Good Health, we can help guide you on this journey to better health. Contact us today for support!

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