Why Diabetes Increases
the Risk of Heart Disease

How much do you know about diabetes
and the link to heart disease and stroke?

Heart disease strikes people with diabetes at significantly higher rates than people without diabetes. Dr. Jeffrey Uzzilia has a special interest in coronary artery disease treatment and prevention. He offered an explanation for the risk of heart disease and stroke for diabetics, “The end process of blood sugar not being regulated properly, can affect the blood vessels themselves and cause stiffness, not only the bigger blood vessels but also, the smaller vessels and the nerves. This can have far-reaching effects on other organs: the kidneys, eyes, the blood vessels themselves. It can also promote atherosclerosis (plaque on the inner walls of your arteries) which is the process that pre-disposes to both cerebral vascular disease or stroke, heart disease, and heart attack.”

For adults at age 60, having type 2 diabetes and cardiovascular disease shortens life expectancy by an average of 12 years. A campaign has been launched to educate people with type 2 diabetes about heart disease and what they can do to reduce their risk. The new, multi-year awareness and education initiative is called Know Diabetes by Heart.

Type 1 Diabetes

Type 1 diabetes is less common than type 2—about 5% of people with diabetes have type 1. In type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, the body attacks it’s own pancreas. “It’s a production of insulin problem,” noted Dr. Uzzilia. “The body decides for whatever reason, whether it’s a virus or predisposition, to attack the beta cells of the pancreas that produce insulin; eventually, the pancreas can’t provide the insulin that the body needs.” Type 1 diabetics must replace their insulin every day, often with medication or by injections.

Currently, no one knows how to prevent type 1 diabetes, but it can be managed by avoiding excess sugars, carbohydrates (non-starchy vegetables), and trans fat. Because their bodies have fluctuating glucose levels, type 1 diabetics often have to plan their exercise and physical activity – even house or yard work, in advance. Usually, they carry orange juice or glucose tablets in the event of a drop in glucose levels. They will monitor their blood sugar levels, sometimes with a quick hand-held monitor, to avoid blood sugar spikes when their insulin isn’t functioning effectively.

Type 2 Diabetes

If you have a mother, father, brother, or sister with diabetes, you are at risk for type 2 diabetes. “Type 2 is a different problem, in that, insulin is being produced, but it’s not being used properly by the body,” said Dr. Uzzilia. “The process for type 2, while there may be a genetic disposition, is lifestyle related. It’s related to inactivity, carrying excess weight, and dietary choices.” There is no cure for type 2 diabetes, but it can be managed.

Dr. Uzzilia said changes in what we eat plays a significant role in the advancement of type 2 diabetes. “I think over time we have started to eat more and more simple sugars, both sodas and white sugars (like pasta, rice, and potatoes),” he said. “Those types of food sources are predisposed to the development of type 2 diabetes.” Balancing the food you eat with exercise and medicine (if prescribed) can keep your blood glucose in a healthy range.

Living with type 2 diabetes puts you at higher risk for heart disease and stroke. Dr. Uzzilia outlined how over time glucose can lead to increased fatty deposits or clots on the insides of the blood vessel walls. “Just as diabetes can affect the small blood vessels that lead to the heart, it can affect those same vessels that are important for the brain like the carotid arteries and the aorta, that tends to be the major source of stroke in the body,” he said. These clots can narrow or block the blood vessels in the brain or neck, cutting off the blood supply, stopping oxygen from getting to
the brain and causing a stroke.

Talk with your doctor

The American Heart Association and American Diabetes Association are urging that adults talk with their doctor at their next appointment about diabetes and the link to heart disease and stroke. Dr. Uzzilia points out that for a complex disease, testing for it is quite simple. “There is a glucose level (fasting glucose level) that can be checked randomly; we can check a fasting glucose level, sometimes we’ll give a glucose tolerance test where we will give the body some sugar to test their tolerance.” People with diabetes can also take an A1C test to find their average blood glucose level over the past three months. This is different from the blood glucose checks that you do every day. The higher your A1C number, the higher your blood glucose levels have been during the past three months.

The CDC reports that 29.1 million people in the United States are living with diabetes: keyword living. “There are many success stories that I try to share with patients,” shared Dr. Uzzilia. “Most people don’t want to be on a number of medications. The very early on-set, when their sugar or blood pressure first goes up, most patients make a dramatic change in their lifestyle. They quit smoking, they say, ‘I’m going to get that exercise I need, I’m going to set that activity time aside.’ They start modifying their diet. I’ve seen people come full circle, where they were on multiple medications, at risk for heart disease, had high blood pressure, had diabetes, and by the end of reaching their modification goals, they’ve lost weight, and in a lot of cases they’ve come off medications which is fantastic!”

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.