The Link Between Type 2 Diabetes and Heart Disease

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Type 2 diabetes raises your odds of developing heart disease, as does prediabetes. If you’ve been diagnosed with either, start paying attention to your heart health now.

“You don’t need to have diabetes before you get heart disease,” says endocrinologist Matthew Freeby, MD, an assistant clinical professor of medicine and director of the Gonda Diabetes Center at David Geffen UCLA School of Medicine. “We know there’s a higher risk of heart disease in people with prediabetes.”

Prediabetes occurs when your body can no longer keep your blood sugar level within a normal range. Unchecked, over time it may rise high enough to warrant a diagnosis of diabetes. Elevated blood sugar, in both prediabetes and diabetes, can harm your blood vessels and the nerves that keep your heart and blood vessels functioning properly. Over time, this can cause heart disease.

But, says Freeby, that’s only part of the picture. Most people diagnosed with prediabetes or diabetes also have other conditions that threaten the heart: high blood pressure, high cholesterol, and obesity. Such health problems, collectively known as metabolic syndrome, boost the likelihood of blood clots as well as damage to the arteries in your heart.

“Managing the risk of heart attack and stroke is less about managing diabetes than it is about reducing the risk factors that go along with diabetes,” says Freeby.

Both diabetes and heart disease may lead to heart failure, which may weaken your heart so it can’t function properly. It’s one of the earliest, most serious, and most common heart problems in diabetes. Diabetes often worsens heart failure, while heart failure can complicate your diabetes treatment.

“We only have so many tools at hand for lowering your blood sugars, and some of these are medications that should not be used if you have heart failure,” says Freeby.

Fortunately, you have your own tools to protect your heart. Reduce your risks of heart disease — and diabetes if you have prediabetes — by modifying your lifestyle in ways that will improve your overall health. It may not be easy, but you don’t have to make dramatic changes overnight. Some areas to focus on:


Slim down. Excess weight burdens your heart. To shed pounds, start with small, attainable goals. “You don’t need to set a lofty goal for weight loss” says Freeby. “That 5 or 10 pounds you do lose will have a big, positive effect.”

Get moving.
Exercise will help keep your heart healthy. Don’t aim to do too much too soon or you’ll risk injury. Focus, instead, on simply getting started. “Find an activity that you like to do that won’t cause you pain and that will keep you coming back day after day,” Freeby says.

Eat right. Go easy on your favorite foods, especially processed foods and simple sugar treats. Discuss your daily meals with a dietitian and understand you aren’t alone. “Every person is different,” says Freeby, “but we all struggle to make dietary modifications.”

Get screened. Freeby recommends regular screening for diabetes, as early diagnosis can modify the course of diabetes-related complications.

Care for yourself. To help manage diabetes risk or the disease if you have it, try relaxation techniques to reduce stress, get a good night’s sleep, and maintain an active social life, says Freeby.

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Matthew Freeby, MD, endocrinologist, assistant clinical professor of medicine, and director of the Gonda Diabetes Center, Los Angeles.

Cleveland Clinic: “How to Protect Your Heart When You Have Prediabetes.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Diabetes, Heart Disease, and Stroke.”

National Heart, Lung, and Blood Institute: “Heart Failure.”

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