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Can Diabetes Cause Heart Disease?

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Learn How and Why to Protect Your Heart

Posted by Abdallah Bukari, MD

People who are living with type 2 diabetes are typically well aware of the additional health risks that come with the disease, like eye and nerve problems. But there is another serious problem that they often don’t know about: the increased risk for many forms of heart disease, including heart failure.

Heart disease is up to four times more likely to occur in people who have diabetes compared to those who don’t. And the longer a person has diabetes, the greater the chance that the disease will end up affecting their heart.

I specialize in treating patients with advanced heart failure, and many of the patients I see in my practice have type 2 diabetes. What I want people with type 2 diabetes to know is that you can often avoid — or at least delay — heart disease (including heart failure) with careful management of diabetes and its risk factors.

The first step is to understand the ways diabetes can take a toll on the heart.

Multiple shared risk factors between diabetes and heart disease

Anyone can develop risk factors for heart disease, but people with diabetes tend to have several of the common risk factors, including high blood pressure, high cholesterol, and an unhealthy weight.

Diabetes itself can also directly affect the heart. High blood sugar can harm blood vessels, causing them to stiffen,narrow and become blocked. These blockages can slow or stop the flow of blood to the heart, resulting in heart disease and an increased risk for chest pain, heart attack, or even sudden death.

Thinking about these risks can be worrisome, but I encourage people with diabetes to focus on what they can control: heart failure and other types of heart disease can be prevented — even when you have diabetes. And if you do develop a heart condition, there are still many ways you can protect your health and feel your best.

How to protect your heart

When you’re living with diabetes, keeping your blood sugar under control helps to protect your heart.

That’s why I encourage everyone with type 2 diabetes — including my patients with diabetes who already have heart disease — to take these steps:

  • Follow a healthy diet. Emerging research suggests that a Mediterranean or DASH-style diet (one that is rich in fruits, vegetables and whole grains) may help people with diabetes and heart failure stay healthier. Try to make fresh fruits and vegetables, lean protein, and whole grains the mainstays of your diet, and drink plenty of water. Limit your intake of processed or sugary foods, sugary drinks, and alcohol.
  • Be active 30 minutes a day. Regular exercise can help control blood sugar levels and reduce the risk of heart disease. Make it a goal to get 30 minutes of exercise most days of the week, even if you have to break that 30 minutes into smaller chunks of activity throughout the day. I often recommended brisk walking to my patients. If a patient already has heart disease, I talk to them about how to exercise safely.
  • Work toward a healthy weight. Excess weight can make it harder to manage your health. But for people who are overweight, losing just 5% to 7% of your body weight may lower your blood sugar levels and reduce some heart disease risk factors. For a 200-pound person, that’s a loss of just 10 to 14 pounds.
  • Manage the ABCs. That stands for A1C, blood pressure, and cholesterol. Work to keep your A1C level within your recommended target range. For many people, that’s around 7%. Aim for a blood pressure below 140/90 and get your cholesterol checked regularly, at least every five years or more if your doctor recommends it.
  • Stop smoking if you smoke. It’s one of the best things you can do for your health. Quitting smoking can reduce your overall risk for heart disease and make it easier to control your blood sugar levels. I often refer my patients who smoke to the Temple Smoking Cessation Program, which has helped many of them stop smoking.
  • Keep stress levels low. Practice stress-relief techniques, such as yoga or deep breathing, or talk about your stress with someone you trust. Over time, too much stress can make it harder to keep your blood sugar and blood pressure within healthy ranges. What’s more, many people deal with stress by engaging in unhealthy behaviors like overeating or drinking too much alcohol, which are not good for your heart or your diabetes.
  • Get enough sleep. Obtaining the recommended 6 to 8 hours of sleep each night is another way to manage your stress levels. Plus when you’re well rested, you have more energy to practice healthy habits.
  • Take medications as prescribed. Your doctor may prescribe medicine for high blood pressure, high cholesterol, or high blood sugar. Drugs like SGLT-2 inhibitors (Invokana, Farxiga, Glyxambi, etc.), in particular, have been shown to lower blood sugar levels in adults while reducing their risk for heart failure. These drugs can also help manage heart failure in those who have it. Stay on top of your prescriptions and don’t miss a dose.

Recognize the signs of heart failure

It’s important for people with type 2 diabetes to recognize the early warning signs of heart failure because they are at higher risk of developing this heart condition.

I find that heart failure can “sneak up” on people. The condition doesn’t always cause noticeable symptoms, and when it does, you might chalk-up the symptoms to something else. But the earlier heart failure is recognized and treated, the better it can be managed. Possible symptoms of heart failure include:

  • Chest discomfort or shortness of breath from activities like walking or exercising
  • Fatigue or weakness
  • Persistent coughing or wheezing or coughing that produces pink-tinted mucus
  • A resting heart rate above 100 beats per minute, or a heartbeat that feels irregular
  • Nausea or lack of appetite
  • Swollen feet or ankles, which can be caused by fluid retention
  • Very rapid weight gain, which can be caused by fluid retention

Heart failure tends to get worse over time, but early diagnosis and treatment can help relieve symptoms and stop or delay the condition from getting worse. That’s why it’s crucial to make an appointment with a cardiologist if you have symptoms of heart failure.

Do your heart a favor — get screened!

The sooner any kind of heart problem is found and treated, the better. If you have diabetes, schedule an appointment at the Temple Heart & Vascular Institute to get simple screening tests that can identify possible heart conditions. Additionally, if you are concerned that you may be at risk for developing diabetes, or have been told you are at risk for developing diabetes, then learn about how you can get involved with our 25-week diabetes prevention program.

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Abdallah Bukari, MD

Dr. Bukari is a cardiologist at Temple Chestnut Hill Cardiology. His clinical interests include preventive cardiology, echocardiography and pacemaker monitoring.

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