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Heart disease and diabetes

Updated: Dec 4, 2018

Heart disease, coronary heart disease in particular, has been identified as a major cause of morbidity (undesirable complication) and mortality (death) among all types of diabetes. In fact, people with type 2 diabetes are at equal risk for a heart attack as those who have previously had one. Now THAT is frightening.


Not only does prolonged high blood sugar cause damage to blood vessels, it can damage the nerves that control those blood vessels. PWD are at an increased risk for the comorbidities caused by this pathophysiology; hypertension and hypercholesterolemia (high cholesterol levels). Both of these conditions are significant cardiac risk factors. Add diabetes to the mix, and you’ve got a pretty scary cardiac trifecta.

This is why clinicians are such sticklers about blood pressure and cholesterol levels!

An elevated blood pressure means that the heart is working harder to pump blood through the vessels. It is usually present at the diagnosis of type 2 diabetes, but does not typically occur in type 1 until the onset of renal disease. I cannot stress this enough….blood pressure control in DM is SO IMPORTANT. In fact, The United Kingdom Prospective Study found that just a 10mmHg reduction in mean systolic pressure was associated with a 12% risk reduction in ANY diabetes complication, including cardiovascular disease. Isn’t that amazing?

Cholesterol is made in the liver and is classified into two main types; LDL and HDL. The LDL is considered the “bad cholesterol” and can build up and clog blood vessels. Additionally, elevated triglycerides (another type of blood fat) can be a contributing cardiac risk factor. Elevated TG levels are associated with insulin resistance, insulin deficiency, and obesity. Study after study has reinforced that statin therapy can improve diabetic cardiovascular outcomes even in those with diabetes and without known cardiovascular heart disease.

Additional cardiac risk factors include; tobacco use, microalbuminuria (urine protein-early sign of kidney disease), lack of regular exercise, obesity and belly fat, and family history.

This information is certainly not meant to scare any of you. I only mean to encourage all of you to be proactive about your disease. Both hypertension and hypercholesterolemia can be treated with a combination of diet, exercise, and medication. Don’t forget to talk to your clinician about the comorbidities that can be associated with DM and how to reduce your risk. The American Association of Clinical Endocrinologist suggests a BP of  <130/<80mmHg and an LDL of <70mg/dL (or <100mg/dL if no other risk factors) to avoid disease complications.

Managing diabetes is difficult and it puts us at risk for a lot of scary things. But keep in mind, there are many things that we can do to reduce our risk. Keep your head up and always stay proactive!

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