The link between diabetes and heart disease is backed by strong clinical evidence.

Globally, approximately 32.2% of individuals with type 2 diabetes mellitus (T2DM) are affected by cardiovascular disease (CVD). CVD remains a major cause of mortality among people with T2DM.

Dr. Dinesh Kumar Mittal, a renowned cardiac surgeon who has treated many diabetic patients, points out, “Heart disease in diabetes patients doesn’t always show symptoms right away, which is why preventive care is crucial. Diabetes patients should aim for a comprehensive heart health plan.”

This blog explores how diabetes causes cardiovascular disease and the role of lifestyle in managing diabetes and heart health.

What is the Link Between Diabetes and Heart Disease?

According to the American Heart Association, adults with diabetes are 2-4 times more likely to suffer from heart disease than those without diabetes.

The connection between diabetes and cardiovascular disease arises from the systemic effects of high blood sugar levels over time. Chronic hyperglycemia damages various systems in the body, including blood vessels, nerves, and the heart itself.

Blood Vessel Damage and Atherosclerosis

High blood sugar levels damage the endothelium, the thin lining inside blood vessels. This damage promotes atherosclerosis, a condition where arteries become stiff and narrow due to plaque buildup. Narrowed arteries reduce blood flow, increasing the risk of heart attacks and strokes.

Inflammation and Its Role in Heart Health

Diabetes triggers chronic inflammation, which accelerates plaque formation in blood vessels. Inflamed plaques are prone to rupture, leading to clot formation and potentially life-threatening events like heart attacks or strokes.

Hypertension, Cholesterol, and Diabetes

Many diabetes patients also experience hypertension (high blood pressure) and dyslipidemia (abnormal cholesterol levels). These conditions compound the risk of cardiovascular disease:

• Hypertension forces the heart to work harder, weakening it over time.
• Dyslipidemia involves high levels of LDL cholesterol and triglycerides, which contribute to arterial plaque buildup.

Aneurysms in Diabetes Patients

Diabetes increases the risk of aneurysms- bulging, weakened areas in blood vessels that can rupture and cause internal bleeding. Addressing this risk often involves interventions like aneurysm repair surgery, particularly in high-risk individuals.

What are the Risk Factors for Heart Disease in Diabetic People?

People with diabetes are at a higher risk of developing heart disease due to a combination of factors that often coexist with the condition. These include:

• Chronic Hyperglycemia
• Hypertension
• Dyslipidemia
• Obesity
• Smoking
• Sedentary lifestyle
• Family history

Dr. Dinesh Mittal, a cardiac surgeon with 30+ years of experience, says, “Many of my patients with diabetes are unaware that heart disease risk is not only about blood sugar control but also about preventing long-term damage to blood vessels. I strongly encourage my patients to educate themselves about the relationship between diabetes and cardiovascular health.”

How to Prevent Heart Disease in Diabetes Patients?

While the risks are significant, preventing heart disease in diabetes patients is attainable with the right strategies.

Managing Blood Sugar for Heart Health

Maintaining stable blood sugar levels is a pivotal aspect of both diabetes management and heart disease prevention. Effective glycemic control reduces the risk of complications like atherosclerosis and chronic inflammation.

• Target HbA1c Levels: The goal for most diabetes patients is an HbA1c level below 7%, though this target can vary based on individual health conditions.
• Use of Medications: Drugs like metformin and SGLT2 inhibitors lower blood sugar and have proven cardiovascular benefits. However, it is never recommended to start medications without a doctor’s prescription.

Controlling Blood Pressure and Cholesterol

For people with diabetes, managing blood pressure and cholesterol levels is just as important as controlling blood sugar.

• Blood Pressure Goals: According to the American Diabetes Association, diabetes patients should aim for blood pressure below 140/90 mmHg, with lower targets for those at higher cardiovascular risk.
• Cholesterol Management: Medical professionals sometimes prescribe statins to lower LDL cholesterol and reduce cardiovascular risk.

What is the Role of Lifestyle Changes in Managing Diabetes for Heart Health?

Lifestyle modifications are one of the most effective ways to prevent heart disease in diabetes patients. Let’s explore the key aspects.

• Regular Physical Activity: Exercise enhances insulin sensitivity, lowers blood sugar levels, and improves cardiovascular fitness. Aim for at least 150 minutes of moderate-intensity aerobic activity, such as brisk walking, swimming, or cycling, per week.

• Dietary Adjustments: A heart-healthy diet incorporates fibre-rich foods like vegetables, fruits, and whole grains while minimising processed sugars and saturated fats. Besides, a low-sodium diet and regular exercise can significantly improve both blood pressure and cholesterol levels.

• Smoking Cessation: Smoking significantly increases the risk of cardiovascular disease, especially in diabetes patients. Quitting smoking is one of the most impactful steps to protect heart health. Excessive alcohol consumption can disrupt blood sugar levels, leading to dangerous fluctuations and increasing the risk of hypoglycemia (especially when on insulin or certain medications).

• Stress Management: Chronic stress can negatively affect both blood sugar and blood pressure. Stress-reducing techniques such as yoga, meditation, and mindfulness can improve overall health. You can also connect with mental health professionals and therapists to form effective stress management techniques.

One of the patients of Dr. Dinesh, who had diabetes, underwent CABG. She expressed, “As a diabetic patient, I never thought I’d face severe heart problems until I started experiencing chest pains. Dr. Mittal promptly diagnosed blocked coronary arteries and recommended CABG. Post-surgery, I have a renewed sense of hope and energy, and I am committed to staying heart-healthy moving forward.”

When to Seek Help?

If you have diabetes and experience symptoms such as chest pain, shortness of breath, extreme fatigue, or leg swelling, you should seek immediate medical attention, as these could be signs of heart disease. Additionally, regular check-ups with your healthcare provider are essential for monitoring your heart health and adopting preventive measures.

Conclusion

The link between diabetes and cardiovascular disease is undeniable, but the good news is that heart disease in diabetes patients is mainly preventable. By managing blood sugar, controlling blood pressure and cholesterol, and embracing a heart-healthy lifestyle, individuals with diabetes can significantly reduce their risk of cardiovascular complications.

Book a consultation with a medical professional to assess your cardiovascular risk and explore tailored preventive strategies!

FAQs

1. Can type 1 diabetes also increase the risk of cardiovascular diseases?

Yes, chronic high blood sugar levels in Type 1 diabetes can damage blood vessels and increase the risk of conditions like heart attacks and strokes.

2. Should I see a cardiologist if I have diabetes?

Yes, regular consultations with a cardiologist can help monitor heart health, detect early signs of cardiovascular disease, and create a personalised prevention plan.

3. How do doctors diagnose heart diseases in diabetic people?

Doctors can detect signs of heart disease using ECG, echocardiogram, stress tests, coronary angiography, or blood tests.

4. What is the impact of sleep on diabetes and heart health?

Poor sleep can worsen insulin resistance, increase blood pressure, and contribute to weight gain, all of which elevate the risk of heart disease in people with diabetes.

5. Can managing diabetes help reverse the damage caused by heart disease?

While it can’t be completely reversed, managing diabetes reduces the progression of heart disease and prevents complications.

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