How Does Diabetes Affect My Heart?

A diagnosis of diabetes may put your focus on what your blood sugar levels are. But long-term, it also ups your risks to your heart.

Diabetes is a major risk factor for heart disease. In fact, people with diabetes are two to four times more likely to develop cardiovascular disease, according to the American Heart Association.

Why Does Diabetes Control Impact My Heart?

“People with higher blood sugars or uncontrolled diabetes have more sugar in their blood pumping through the body,” explained Madilyn Sheerer, RD, CDCES, certified diabetes specialist at Franciscan Physician Network Diabetes & Endocrinology Specialists in Indianapolis. “If there are high amounts of sugar in the blood, it’s syrupy in a way and difficult to get to your tips of your fingers and toes as well.

“High blood sugar levels can damage the blood vessels and the heart and increase your risk of heart attack and stroke. It’s like how a canyon is made. Pumping through, it can damage things along the way. It’s why high blood sugar affects the nerves as well.”

What Should I Do To Protect My Heart If I Have Diabetes?

People with diabetes are likely to have other medical conditions that impact your heart’s health, including high cholesterol, high blood pressure and high triglycerides.

Common strategies to help reduce the risk of heart disease if you have diabetes include:

• Diet and exercise
• Managing blood sugar and cholesterol levels
• Not smoking
• Not drinking alcohol.

Whatever the approach to managing your diabetes, the overall goal is the same: Keeping your blood sugar, blood pressure, and lipids (cholesterol and triglycerides) within a healthy range. By controlling these, you can dramatically reduce your risk of heart disease, blindness, kidney disease, amputations and other diabetic complications.

Can A Diabetic Diet Help My Heart?

Many of the diet changes recommended for people with diabetes help not only their blood sugar, but also their heart health. The right foods can provide dramatic protection. For instance, a study of more than 22,000 men, reported in the International Journal of Epidemiology, found that men who ate two-and-a-half servings of vegetables every day lowered their risk of coronary heart disease (blockages in the arteries that feed the heart) by 20 percent compared with men who ate one serving each day. Each additional serving cut the risk by another 20 percent. The protection was especially strong among men who smoked or were overweight.

Not only does more produce offers more vitamins and antioxidants, but it’s also a way to ensure you’re getting more fiber in your daily diet.

“The higher fiber, the more friendly to your blood sugar,” Sheerer said.

Some types of fats, such as omega-3 fatty acids found in fish, may help lower triglycerides and provide other benefits; try to eat fish at least twice a week. Talk to your doctor, registered dietitian or diabetes educator about how to increase your intake of good fats while cutting down on the "bad" fats.

“When we deal with the heart, we often think about watching our fat intake,” Sheerer said. “When diabetes plays a role you also should limit non-nutritious sugary food like candy or soda which can affect your triglycerides.”

An easy starting point if you’re looking to shift your diet? Look at the mix of foods you’re putting on your plate.

“First work on the balance aspect – have fruits, vegetables, carbohydrates and proteins,” Sheerer said. “Going back to the basics puts you at a great starting point before you even look at labels.”

How Does Exercise Help Heart Health And Diabetes Control?

Researchers found that people with type 2 diabetes who increased their exercise by just 38 minutes a day (2.2 miles, or 4,400 steps) over a two-year period significantly reduced their blood sugar, triglycerides, total cholesterol and blood pressure, resulting in a two-fold decrease in the risk of heart disease.

Like any other muscle, the heart gets stronger with exercise. If you work out regularly, your heart muscle will grow a little larger and stronger, allowing it to move more blood with each beat. As a result, it takes fewer beats to get you through the day. Your heart rate drops, and your heart will enjoy a well-deserved rest.

Even more important, exercise helps protect your arteries -- where heart attacks get their start. Regular exercise removes LDL ("bad") cholesterol from your blood. If you have too much of this fatty substance, it starts sticking to the walls of your arteries, causing arteriosclerosis, or hardening of the arteries. If the arteries feeding the heart become clogged -- a condition called coronary heart disease -- a heart attack may be just around the corner. The protection doesn't stop there. Exercise also increases your level of HDL ("good") cholesterol, a substance that helps keep your arteries clear.

How Does Cholesterol Affect Your Heart?

Since too much cholesterol contributes to plaque buildup in the arteries, it's best to keep your total cholesterol level below 200 milligrams per deciliter. Anything between 200 and 240 mg/dL is considered worrisome, and a level over 240 is often a serious threat. The basic goal is also to keep your "good" HDL cholesterol high and your "bad" LDL cholesterol level low. If you're a man, your HDL should ideally be at least 40 mg/dL; for women, the American Heart Association recommends an HDL level of at least 50 mg/dL. If you don't already have coronary heart disease and if you have fewer than two of the major risk factors -- obesity, high blood pressure, or a family history of premature heart trouble -- your LDL cholesterol should be below 130 mg/dL (and preferably under 100).

If you already have coronary artery disease or diabetes mellitus and your LDL is over 100, your doctor will probably recommend you take cholesterol-lowering drugs to get your LDL below the 100 mark.

In addition to your HDL and LDL cholesterol levels, your doctor may have you pay greater attention to your triglycerides.

“Triglycerides are directly not impacted by your fat intake; they are more impacted by high blood sugar levels,” Sheerer said. “It’s common for people with high blood sugars to have high triglyceride levels. Fortunately, it’s quite dynamic, constantly changing.”

What Other Steps Should People With Diabetes Take To Protect Their Heart?

Sheerer recommended that if you have diabetes, you take other preventive steps, including:

• Keep your blood pressure under control. Since high blood pressure increases the risk of coronary artery disease and stroke, it's good to keep yours in the optimum range: less than 120/80.
• Increase your movement throughout the day, especially if you are working from home.
• Stay on top of lab work requested by your physician
• Go to your doctor’s appointments.