Diabetes and Cardiovascular Disease: Evaluation, Prevention & Management
1. Cardiovascular disease is a major complication of diabetes and the leading cause of early death among people with diabetes—about 65 percent of people with diabetes die from heart disease and stroke.
The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes.
At least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke.
The more health risks factors a person has for heart disease, the higher the chances that they will develop heart disease and even die from it.
Just like anyone else, people with diabetes have an increased risk of dying from heart disease if they have more health risk factors.
However, the probability of dying from heart disease is dramatically higher in a person with diabetes. So, while a person with one health risk factor, such as high blood pressure, may have a certain chance of dying from heart disease, a person with diabetes has double or even quadruple the risk of dying.
2. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes.
Cardiovascular disease is the leading cause of mortality for people with diabetes.
If you have diabetes your risk of cardiovascular disease rises for a number of reasons. Hypertension, abnormal blood lipids and obesity, all risk factors in their own right for cardiovascular disease, occur more frequently in people with diabetes.
Uncontrolled diabetes causes damage to your body’s blood vessels making them more prone to damage from atherosclerosis and hypertension. People with diabetes develop atherosclerosis at a younger age and more severely than people without diabetes.
Hypertension is more than twice as common in people with diabetes as in people with normal blood glucose levels.
People with diabetes are more likely to have a heart attack or stroke, than people who do not, and their prognosis is worse.
If you have diabetes you can have a heart attack without realizing it. Diabetes can damage nerves as well as blood vessels so a heart attack can be ‘silent’, that is lacking the typical chest pain.
Premenopausal women who have diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of estrogen.
3.High blood glucose in adults with diabetes increases the risk for heart attack, stroke, angina, and coronary artery disease.
The connection between diabetes and heart disease starts with high blood sugar levels. With time, the high glucose in the bloodstream damages the arteries, causing them to become stiff and hard.
Fatty material that builds up on the inside of these blood vessels can eventually block blood flow to the heart or brain, leading to heart attack or stroke. Your risk of heart disease with diabetes is further elevated if you also have a family history of cardiovascular disease or stroke.
Other heart facts to consider:
(a)A person with diabetes who has had one heart attack has a much greater risk of having another.
(b)A middle-aged person who has diabetes has the same chance of having a heart attack as someone who is not diabetic, but already had a heart attack.
(c)People with diabetes develop cardiovascular disease at a much earlier age than others.
(d)People with diabetes who have heart attacks are more apt to die as a result.
4. People with type 2 diabetes also have high rates of high blood pressure, lipid problems, and obesity, which contribute to their high rates of Cardiovascular disease.
Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That’s because people with diabetes, particularly type 2 diabetes, may have the following conditions that contribute to their risk for developing cardiovascular disease.
High Blood Pressure (hypertension)
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High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles.
Abnormal Cholesterol and High Triglycerides
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Patients with diabetes often have unhealthy cholesterol levels including high LDL (“bad”) cholesterol, low HDL (“good”) cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes.
Obesity
Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.
Lack of Physical Activity
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Physical inactivity is another major risk factor for insulin resistance and cardiovascular disease.
Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke.
It’s likely that any type of moderate and/or vigorous intensity, aerobic physical activity—whether sports, household work, gardening or work-related physical activity—is similarly beneficial.
Poorly Controlled Blood Sugars (too high) or Out of Normal Range
Diabetes can cause blood sugar to rise to dangerous levels.
Lowering blood sugar levels could reduce the risk of coronary heart disease in both diabetics and non-diabetics, according to researchers. The researchers found that Hemoglobin A1c (HbA1c)—a measure of long-term blood glucose level—predicts heart disease risk in both diabetics and non-diabetics.
In participants with diabetes, the researchers found a graded association between HbA1c and increasing coronary heart disease risk. Each 1-percentage-point increase in HbA1c level was associated with a 14 percent increase in heart disease risk.
According to the study, the current target for “good” glycemic control is an HbA1c value less than 7 percent. However, the researchers’ analyses suggest that heart disease risk begins to increase at values even below 7 percent.
They found that those study participants without diabetes but who had “high normal” HbA1c levels (approximately 5 percent to 6 percent) were at an increased heart disease risk, even after accounting for other factors such as age, cholesterol level, blood pressure, body mass index and smoking.
Non-diabetic persons with HbA1c levels of 6 percent or higher had almost a two-fold greater heart disease risk compared to persons with an HbA1c level below 4.6 percent.
5.Smoking doubles the risk Cardiovascular disease in people with Diabetes.
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Smoking harms nearly every organ in the body, including the heart, blood vessels, lungs, eyes, mouth, reproductive organs, bones, bladder, and digestive organs.
The chemicals in tobacco smoke harm your blood cells. They also can damage the function of your heart and the structure and function of your blood vessels. This damage increases your risk of atherosclerosis.
Atherosclerosis is a disease in which a waxy substance called plaque builds up in the arteries. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.
Coronary heart disease (CHD) occurs if plaque builds up in the coronary (heart) arteries. Over time, CHD can lead to chest pain, heart attack, heart failure, or even death.
Smoking is a major risk factor for heart disease. When combined with other risk factors—such as unhealthy blood cholesterol levels, high blood pressure, and overweight or obesity—smoking further raises the risk of heart disease.
Smoking also is a major risk factor for peripheral artery disease (P.A.D.). P.A.D. is a condition in which plaque builds up in the arteries that carry blood to the head, organs, and limbs. People who have P.A.D. are at increased risk for heart disease, heart attack, and stroke.
Any amount of smoking, even light smoking or occasional smoking, damages the heart and blood vessels.
For some people, such as women who use birth control pills and people who have diabetes, smoking poses an even greater risk to the heart and blood vessels.
Secondhand smoke also can harm the heart and blood vessels. Secondhand smoke is the smoke that comes from the burning end of a cigarette, cigar, or pipe. Secondhand smoke also refers to smoke that’s breathed out by a person who is smoking.
Secondhand smoke contains many of the same harmful chemicals that people inhale when they smoke. Secondhand smoke can damage the hearts and blood vessels of people who don’t smoke in the same way that active smoking harms people who do smoke. Secondhand smoke greatly increases adults’ risk of heart attack and death.
Secondhand smoke also raises children and teens’ risk of future CHD because it:
Lowers HDL cholesterol (sometimes called “good” cholesterol)
Raises blood pressure
Damages heart tissues
The risks of secondhand smoke are especially high for premature babies who have respiratory distress syndrome (RDS) and children who have conditions such as asthma.
Researchers know less about how cigar and pipe smoke affects the heart and blood vessels than they do about cigarette smoke.
However, the smoke from cigars and pipes contains the same harmful chemicals as the smoke from cigarettes. Also, studies have shown that people who smoke cigars are at increased risk for heart disease.
Smoking or exposure to secondhand smoke damages the heart and blood vessels in many ways. Smoking also is a major risk factor for developing heart disease or dying from it.
Quitting smoking and avoiding secondhand smoke can help reverse heart and blood vessel damage and reduce heart disease risk.
Quitting smoking is possible, but it can be hard. Millions of people have quit smoking successfully and remained nonsmokers. A variety of strategies, programs, and medicines are available to help you quit smoking.
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Causes,Symptoms And Treatment Of Heart Disease In Diabetics
The most common cause of heart disease in a person with diabetes is hardening of the coronary arteries or atherosclerosis, which is a buildup of cholesterol in the blood vessels that supply oxygen and nutrition to the heart.
This buildup of cholesterol usually begins before the increase in blood sugars that occurs in type 2 diabetes. In other words, heart disease almost always has established itself prior to the diagnosis of type 2 diabetes.
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Preventing Heart Disease
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The good news is that there are steps to take to reduce your risk for heart disease if you have diabetes.
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The best way to prevent heart disease is to take good care of yourself and your diabetes.
For more great Health and Nutrition Tips refer to the website positivehealthwellness.com.
If you have any information,questions, or feedback you would like to include in this post.
Please email momo19@diabetessupportsite.com or leave your comments below.
Thanks for your review on diabetes and cardiovascular diseases.This has actually given me a great insight on the dangers involved and how they are relatively connected.
I believe a lot of people suffering from the various types of diseases may not already know this but your review as help educate a lot about the possible dangers. Thanks
Hi Johnson,
Its great that this post made you aware of the numerous dangers of diabetes and cardiovascular disease.
When you have the time i hope you will view this website again as there is a variety of articles here that might interest you!
I guess diabetes reduces the bodys ability to take care of other important bodily functions. That statistic of 68% for those over 65 is quite significant. In the case of a silent heart attack, how does a person know that they had a heart attack? Also, what kind of damage occurs from a silent heart attack? You mentioned type 2 diabetes also increases the risk of heart disease. Is there a greater risk with type 1, or is it just the very existence of diabetes that causes the risk?
Its great to see that you are promoting a stop smoking book. Ive dealt with smokers that want to quit. Even with a very strong desire to quit, people have a difficult time. The withdrawal associated with cessation of smoking can be incredibly uncomfortable and even quite damaging in some cases. It really is a good idea to get a book on how to go about withdrawal to minimize unnecessary damage.
This article is very comprehensive and full of detail. Thanks for taking the time to educate those of us who just dont have time to do the research.
Hi bioelectrobot,
Thanks for leaving such great feedback and questions.
People who have silent heart attacks are more likely to have non-specific and subtle symptoms, such as indigestion or a case of the flu, shortness of breath and tiring easily or they may think that they strained a muscle in their chest or their upper back. It also may not be discomfort in the chest, it may be in the jaw or the upper back or arms.
Some people have prolonged and excessive fatigue that is unexplained. Those are some of the less specific symptoms for a heart attack, but ones that people may ignore or attribute to something else.
A heart attack is a very serious and very sudden condition and occurs when a section of the heart does not receive blood. This lack of blood flow can cause the heart tissue to die and scar. Heart attacks can range from mild to severe affecting areas both small and large areas of the heart. Almost always, heart attacks are life threatening and require immediate attention.
The key to recovering from a heart attack is the speed at which the person received treatment. In the case of a silent heart attack, the person is not aware of the attack and because valuable time is wasted, the heart becomes permanently damaged.
The most important treatment in silent heart attack is restoring the blood flow to the heart.
Restoring blood flow can be accomplished by dissolving clots found in the artery (thrombolysis) or by pushing the artery open using a balloon (angioplasty). Both thrombolysis and angioplasty may be used at the same time.
If you feel you have had a silent heart attack, you may want to take a non-acetaminophen aspirin as studies have shown doing so may help prevent heart damage that can occur from a silent heart attack.
Many people permanently damage their hearts because of pride! If anyone feels they may be having a heart attack, don’t mess around! Seek medical attention immediately !
People who have type 1 or type 2 diabetes can develop diabetic heart disease(DHD). The higher a person’s blood sugar level is, the higher his or her risk of DHD.
First, diabetes alone is a very serious risk factor for heart disease, just like smoking, high blood pressure, and high blood cholesterol.
Second, when combined with other risk factors, diabetes further raises the risk of heart disease. Although research is ongoing, it’s clear that diabetes and other conditions such as overweight and obesity(which is mainly typical in type2 diabetes) interact to cause harmful physical changes to the heart.
Third, diabetes raises the risk of earlier and more severe heart problems.
If you have diabetes, you can lower your risk of DHD.
For example, physical activity can lower your blood pressure, help control your blood sugar level and your weight, and reduce stress.
It’s also very important to follow your treatment plan for diabetes and see your doctor for ongoing care.
Hi
Your site is truly a support for sufferers and how they can find help. I really appreciate the depth of knowledge and the dissemination. I personally did not know the extent of the link until I read your post.
‘Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity’. I don’t quite understand this statement, how can weight loss improve cardiovascular risk as well as increase insulin sensitivity?
It is interesting to note that ‘uncontrolled diabetes causes damage to your bodys blood vessels making them more prone to damage from atherosclerosis and hypertension’. This is something I believe a major proportion of the earth’s population are oblivious to.
Thank you for taking the time to deal with this issue extensively. I will surely be back to learn more and also refer people to this wealth of knowledge. Ignorance is the reason people die from such diseases when there are so many precautions one can take.
You mentioned waist measurement and obesity as a guideline. In some cultures, being obese is a sign of ‘good living’ sad to say.
Well done for your efforts
Kav
Hi Kavinah,
Thanks for giving such positive comments about this website.
You asked a very valid question.
How can weight loss improve cardiovascular risk as well as increase insulin sensitivity?
Insulin sensitivity is the relationship between how much insulin needs to be produced in order to deposit a certain amount of glucose. You are insulin sensitive if a small amount of insulin needs to be secreted to deposit a certain amount of glucose, and insulin resistant if a lot of insulin needs to be secreted to deposit the same amount of glucose.
Insulin resistance, is a major risk factor for the development of Type 2 diabetes.
Insulin sensitivity is how effective the body is as using insulin to reduce elevated blood glucose levels, with a greater efficacy being more ‘sensitivity’ and poorer efficacy being more ‘resistant’. When the body becomes too poor at using insulin to reduce blood glucose levels, type 2 diabetes ensues.
Eating carbs too often (especially simple ones, like sugars), can make us less sensitive to insulin (or more “insulin resistant”). When that happens, we need to produce more insulin than we should need to in order to keep blood sugar stable.
That’s bad. If insulin sensitivity becomes poor, we have trouble digesting carbs and absorbing nutrients, and we gain weight.
If it’s really bad for a long time, the pancreas needs to make more and more insulin because we’re so insensitive to it. Eventually, it gets exhausted and stops being able to release the hormone properly—and that’s when Type 2 diabetes occurs.
Keeping body fat low can improve insulin sensitivity and cardiovascular risk.
There is considerable scientific evidence to show that weight loss can improve insulin sensitivity in individuals with insulin resistance or at risk of diabetes and Cardiovascular disease.
Thank you for giving us a good review on diabetes and cardiovascular diseases. This article has really given me a good information on diabetes. I have a diabetic relative and now i know the dangers and how they are connected. Most people suffering from these diseases may not know. I will have to share this on my facebook wall.Thank you.
Hi Mercy,
I am so happy you found the information on this post helpful.
There are many more articles in this website that you and your family might like to view as they contain vital information about various diabetic topics!
Diabetes is an awful disease and unfortunately I’ve seen too many people with the disease suffer and die. I’ve had family members lose feet and limbs to diabetes. To top it off, add cardiovascular disease to the list of negatives.
There is excellent coverage of the connection between cardiovascular disease diabetes at this website with lots of good, helpful information.
So sorry to hear that some of your family members have lost limbs due to diabetes.
Healthy nerves carry messages to our muscles and organs. Having high blood sugar levels for a long time can damage nerves throughout the body. Also, the older people get and the longer they have diabetes, the more likely they are to have some nerve damage.
Long nerves from the spinal cord send messages to the lower legs and feet. When blood sugar levels stay high, the nerve cells swell and scar. After a while, the nerves can’t send messages to the legs and feet the way they should.
When this happens, it can cause people to lose feeling in their legs and feet, making it hard to sense pressure or pain. It can also cause uncomfortable feelings in the arms and legs, like tingling, shooting pains, or aching. This condition is known as peripheral neuropathy.
Foot injuries that occur without the person’s knowledge can be the first sign of diabetes, especially when accompanied with decreased sensation.
Diabetics who have had problems with any of the following (in the past or currently) need to consider themselves at risk: foot ulcers, toenail infections such as fungus, stress fractures or other single fractures of the foot, slow-healing wounds, bunions, corns and thick calluses.
The bottom line is take care of your feet, look at them daily and see a medical doctor if anything is suspicious. It is important to be evaluated by a medical doctor with an adequate training to determine an accurate diagnosis .
It is very important to do daily foot checks: inspecting all sides, including the bottoms, which can be done best with someone’s help or with a mirror.
During a foot check, any changes in the foot’s shape or color, sense of feeling/sensation, painful areas or skin integrity need to be evaluated. Any new bunions, calluses or corns need to be identified and shown to a medical doctor.