The Big Risk of Diabetes: Heart Disease

Diabetes and Heart Disease: What's the Link?

Although we don't know exactly why people with either type 1 or type 2 diabetes are more likely to develop heart disease, research has found that when high blood glucose levels are not managed well, this can cause damage to the coronary arteries. People with diabetes can also have high levels of insulin that can contribute to the development of fatty deposits or plaque in the arteries.

Coronary artery disease, or hardening of the arteries, is the most common form of heart disease in people with diabetes.

People living with diabetes are also more likely to have conditions related to heart disease such as:

• high blood pressure.
• high levels of bad cholesterol (LDL) and other fats in their blood - which often has no symptoms.
• low levels of good cholesterol (HDL) - the cholesterol that helps reduce the risk of heart disease.
• a thicker left heart ventricle, which can affect how well the heart pumps.

Being overweight is also a risk factor for heart disease.

Additional Risks

The risk of heart disease increases even more if the diabetes is poorly managed. Family history and lifestyle factors, like smoking and being physically inactive, also contribute to the risk. Poorly managed diabetes can result in abnormal cholesterol levels and high blood glucose levels.

Heart disease is even more of a risk for people living with type 1 diabetes, because glucose levels can be harder to manage than for those who have type 2 diabetes. Type 1 diabetes is also more likely to be diagnosed at a younger age, giving heart disease a chance to develop over a lifetime.

Symptoms of Diabetes May Go Unnoticed for about Seven Years-or until There is a Problem

Of the two million Canadians who have diabetes at least one-third don't even know it. The symptoms of diabetes are often silent and it's not until a complication, often heart disease, happens that a diagnosis is made.

Good Diabetes Management: A Three-Way Approach

Three important aspects of diabetes management can reduce the risk of heart disease for a person with diabetes:

1. Control blood glucose levels
   It is very important that people with diabetes keep their blood glucose levels close to their target range.
2. Control high blood pressure
   People with diabetes should have their blood pressure checked by their healthcare provider at every diabetes-related visit.
3. Lower high cholesterol
   People with diabetes should be tested every one to three years to make sure that their cholesterol, lipids and other fats in the blood are normal. People who are being treated with medication to control cholesterol should be tested more often.

Make Preventing Heart Disease a Priority

Diabetes and heart disease is a serious combination. Reducing the risk of heart disease should be a priority for anyone living with diabetes.

Fortunately, good diabetes management can reduce risks of all of the complications of diabetes, including the most serious-heart disease.

Adapted from an article prepared by the Canadian Diabetes Association. This article appeared originally on the Canadian Health Network Web site and has been edited for publication by the Public Health Agency of Canada.