Diabetes Complications

Cardiovascular Disease

People with diabetes are twice as likely to have heart disease or a stroke than people without diabetes. Learn how to stay heart healthy to reduce your risk.


Of diabetes complications, this is one you want to pay close attention to. 

Cardiovascular disease (CVD), where the heart and blood vessels are negatively impacted, is the number one cause of death in people living with diabetes, resulting in 2/3 of deaths in people with type 2 diabetes. And on top of that, people with diabetes are twice as likely to have heart disease or a stroke than people without diabetes. 

However, there is good news. With proper exercise, diet, and diabetes management, you can reduce your risk of getting CVD and the complications that come with it. If you’re living with type 2 diabetes, we have resources to help at KnowDiabetesByHeart.org

What are the different types of CVD?

When you’re in good health, blood vessels are free of restrictions and allow blood pumped from the heart to travel everywhere in your body. And with the blood, oxygen and nutrients flow, too.

Things start to get dicey when blood does not flow properly. In the case of atherosclerosis, blood vessels stiffen and become narrow due to fatty plaque build-up. This lack of blood-flow can leave your heart without enough oxygen, causing coronary heart disease. 

And it doesn’t just affect your heart, it can cause problems in any blood vessel in your body. If it happens to the vessels in your legs, it can cause peripheral artery disease, and if in the brain—stroke. 

Risk Factors:

  • Diabetes
  • High blood pressure
  • High LDL (bad) cholesterol and triglycerides
  • Low HDL (good) cholesterol
  • Too little physical activity
  • Smoking
  • Being overweight or obese 

This form of CVD occurs when the muscles in the heart become too weak to pump blood properly and your heart becomes unable to supply enough blood to all parts of your body. 

Risk Factors:

  • Diabetes
  • Coronary heart disease
  • High blood pressure 

An irregular heartbeat is caused when structural changes or damage to the heart disrupt the electrical messages that keep the heart beating. At its worst, arrhythmias can cause death via cardiac arrest, through loss of blood flow to the heart. 

Take emergency action.

If you feel any of the following symptoms, call 911 immediately to prevent further damage to your heart, brain, and blood vessels.

Heart Attack:

  • Chest pain or discomfort, tightness, pressure
  • Fullness—this might feel like indigestion or heartburn
  • Discomfort in one or both of your arms, back, jaw, neck, or upper abdomen
  • Shortness of breath
  • Sweating
  • Indigestion, nausea, or vomiting 
  • Tiredness, fainting, or light-headedness

Heart Failure:

  • Shortness of breath
  • Weakness
  • Nausea
  • Quick or irregular heartbeat
  • Coughing with pink-tinged mucus
  • Fatigue
  • Swelling of the feet and ankles (from fluid retention)

Stay on top of your heart health.

The best way to maintain your heart health is to manage your diabetes. Try to keep your blood glucose (blood sugar) in-range for as long and as often as you can. Diet, exercise, taking your insulin and medication as prescribed, attending your doctor visits, and seeking support from medical professionals, family, and friends will all help you get there. 

In the meantime, it’s best to frequently check your A1C, LDL, and blood pressure. 

At every office visit:

  • Check your blood pressure
  • Talk about your blood glucose meter readings. Take along your meter/logbook
  • Check your weight and talk about ways to reach a healthy weight
  • Talk about what you eat
  • Discuss any lifestyle, work, or emotional changes
  • Discuss your physical activity
  • If you smoke, talk about ways to quit
  • Remove shoes and socks to have your feet checked
  • Talk about all the medicine you take, including over-the-counter pills, herbs, vitamins, and other supplements
  • Ask if you should take aspirin to lower your chances of having a heart attack
  • Ask any remaining questions you have about your diabetes care

Every three to six months, have your A1C checked by your doctor. A1C gives your average blood glucose over the past two to three months. eAG is your A1C reported in the numbers your blood glucose meter shows.

Once a year, have a dilated eye exam to check for eye problems, get a flu shot, and have a complete foot exam. 

Every five years, have your cholesterol checked—and check more often if it’s not on target.

Live heart-healthy!

  • Exercise—The optimal time you should spend per week exercising is 150 minutes. You can break this up however you like over the week and be sure to do exercises you enjoy! The best type of exercise is the one you’ll actually do—learn more and get inspired
  • Sit less—Sitting less and exercising go hand-in-hand. Get up and walk around every 30 minutes to get your heart pumping. Find more tips to break a sitting streak.
  • Manage weight—If you’re already at a healthy weight for your age and height, you’re good to go! If needed though, losing even 10–15 pounds makes a big difference. Get the facts on weight loss.
  • Take medication—Taking your medications as directed by your doctor is one of the best defenses against CVD. If you have trouble remembering, try setting an alarm or use a pill box. 
  • Eat well—Use the Diabetes Plate Method to create healthy portions without thinking about it—the method does all the thinking for you!  
  • Manage stress—Mental health is extremely important if you live with diabetes for your emotional and physical well-being. Stress hormones can lead to high blood pressure and make it more difficult to have good diabetes management. 
  • Follow up with your care team—Communicate with your care team, and yourself, to get the best care you can from the health professionals dedicated to your wellness.
  • Attend a diabetes education class—Learn how to manage your diabetes confidently and independently with the expert guidance (often covered by insurance) of health professionals. Find a diabetes education program near you.
  • Sleep better—Get those six to eight hours of restful sleep to reduce stress hormones and feel your best to tackle the days ahead. 
  • Know your numbers—Use a log or chart to keep track of numbers like your A1C, blood pressure, blood glucose, and cholesterol. Do a deep dive of the numbers you should know.