In this article, we will discuss heart disease and diabetes, their effects, and management. The first part of the article will focus on the heart and different heart disease risk factors. This part will be followed by disease management when diabetes is another comorbid disease in the human body.


Figure 1. Image showing chronic complications of diabetes. The image is taken from


An introduction to heart disease. Heart disease is a life-threatening disease. It is the main reason for death in both sexes. Diabetes seems to increase the risk of heart disease and stroke compared to people without the condition. This can occur in younger individuals too.

But there is a good side as well. If you have diabetes, for instance, you can protect your heart and health by controlling your blood glucose levels. Another way of protecting yourself is to control your blood pressure and cholesterol levels. Additionally, you can improve your heart health and minimize your risk for heart disease by making some lifestyle changes.

What is heart disease?
Heart disease is associated with various issues many of which are brought on by the atherosclerosis process. Plaque accumulation in the artery walls leads to the development of atherosclerosis. The arteries get more congested as a result, making blood flow more difficult. If the blood flow is then blocked, this can result in a heart attack or stroke. Chest pain or sudden death may also occur.

Moreover, heart disease is related to the term “cardiovascular disease”, which also describes many aspects of blood circulation in the body. This one includes all types of heart disease,
stroke, and blood vessel disease. The most prevalent kind is “coronary artery disease,” which affects the heart’s blood flow.

Coronary artery disease occurs when the arteries near your heart are narrowed due to atherosclerosis. The plaques are made of cholesterol deposits; they make the inside of arteries narrow and decrease blood flow. This process is called the hardening of the arteries which decreases blood flow to the heart that can cause, as mentioned above, a heart attack. This can also flow to the brain and can cause a stroke.

There is also another similar disease to coronary artery disease that it’s called the peripheral arterial disease. It consists of blockages in the arteries of the legs and feet, and is often the first sign that a person with diabetes will show as having a cardiovascular disease.

How diabetes affects your heart and what increases your chances of heart disease and stroke?
Blood arteries and the nerves that control your heart might be harmed by high blood sugar. People with diabetes are also more likely to have another condition that raises the risk of heart disease:

  1. High blood pressure increases the force of blood through your arteries and can damage artery walls. The risk of heart disease is increased when diabetes and high blood pressure coexist.
  2. High LDL cholesterol levels can damage arterial walls by forming plaque. Consequently, your chance of acquiring heart disease increases. HDL is the “good cholesterol” and higher levels of HDL reduce the risk of heart disease. To keep high HDL levels and low LDL levels (which are bad for your heart disease) you need to eat more plant-based food and get regular physical activity.
  3. Another type of body fat is triglycerides, which are thought to contribute to hardening of the arteries.

However, people need to be careful because sometimes heart diseases can be asymptomatic. A simple blood test can tell your LDL, HDL, and triglyceride levels.

Also, your risk of heart disease is greater if you are a male rather than a female, either if you have diabetes or not. There are some other factors that can raise your risk of heart disease:

  1. Smoking, which increases your chances of developing other long-term problems like:
    • lung disease
    • lower leg infections and ulcers
    • foot or leg amputation
    But, if you quit smoking you will have a high possibility to have a healthier heart:
    • There may be a lower risk for heart attack
    • Your blood glucose and pressure, and cholesterol levels may improve
    • You might have better blood circulation.
  2. Being overweight or obese
    • Being obese or overweight makes the management of diabetes difficult and increases the chances of developing heart disease and high blood pressure, among other health issues. However, if you follow a healthy plan and exercise daily, this may lower your blood glucose and reduce the need for medicines. Also, even belly fat around your waist (even if you’re not overweight, can raise your chances of developing heart disease).
  3. Not getting enough physical activity
  4. Eating a diet high in saturated fat, cholesterol, and sodium (salt)
  5. Drinking too much alcohol
  6. Having a family history of heart disease.

What are the warning signs of heart attack and stroke?
Warning: if you have any of these warning signs of a heart attack call 9-1-1 right away!

  • pain or pressure in your chest that lasts longer than a few minutes or goes away and comes back
  • pain or discomfort in one or both of your arms or shoulders, your back, neck, or even your jaw shortness of breath
  • sweating or light-headedness
  • nausea
  • feeling very tired

Women are predisposed to experience more of these symptoms. People with diabetes-related nerve damage may not notice any chest pain. However, if diagnosed with angina, knowing how to seek medical help becomes crucial.

  • weakness or numbness on one side of any body part
  • confusion, trouble talking, or understanding
  • loss of balance or trouble walking, and feeling dizzy
  • sudden headache
  • trouble seeing out of one or both eyes.

How can I lower my chances of heart attack or stroke if I have diabetes?
We can adopt a healthy diet by consuming more lean protein, whole grains, and fresh fruit and vegetables while consuming fewer processed foods. Consuming more water and less alcohol is important too.

We need to aim for a healthy body weight. If you’re overweight, and you try to lose even the modest amount of weight, that can lower your triglycerides and blood sugar levels.
We need to be physically active. Being physically active makes your body more sensitive to insulin (the hormone that allows cells in your body to use blood sugar for energy), consequently helping diabetes management. Additionally, it lowers your risk of heart disease and regulates blood sugar levels. Nevertheless, aim to engage in 150 minutes a week of moderate exercise by walking.

We need to manage the ABCs:
Your diabetes ABCs can assist you in controlling your cholesterol, blood pressure, and blood sugar. If you have diabetes, it is recommended to give up smoking to reduce the risk of heart disease.

What is diabetes’ ABCs?

  • A stands for A1C test to measure your average blood sugar over 2 to 3 months
  • B tries to keep your blood pressure below 140/90mm Hg
  • C manages your cholesterol levels
  • s stands for stop smoking or don’t start

We need to manage stress. Stress can raise your blood pressure and lead to unhealthy behaviors, such as drinking too much or overeating. Instead, visiting a mental health counselor or trying meditation is recommended. Your doctor may prescribe medicines that can help to keep your blood sugar, blood pressure, cholesterol, and triglycerides close to your target levels.


Figure 2. Image showing some statistics about diabetes and heart disease. The image is taken from Medtronic.


Diabetes educator
It is recommended to work with a diabetes care and education specialist so they can help a person avoid health complications such as heart disease. They offer support and solutions that may be beneficial. It is recommended to consult with your physician before getting in contact with a diabetes educator.
In conclusion, in this article we identified the relationship between heart disease and diabetes, we listed some warning signs of heart disease, and provided recommendations to lower the chances of a heart attack or stroke in people with diabetes.

© COPYRIGHT: This article is the property of We Speak Science, a non-profit organization, co-founded by Dr. Detina Zalli and Dr. Argita Zalli. The article is written by Zoi Semini.