Dr. Ahmed Both diabetes and cardiovascular disease rank in the top 10 causes of death worldwide. This deadly combination affects around 1 to 3 in males and from 2 to 5 in females.
Diabetes is characterized by increased blood sugar levels, while CVDs is an umbrella term used for heart and blood vessel pathologies.
The two are mostly a risk factor for each other, and people with diabetes are always at an increased risk of developing a heart abnormality.
In this blog, we will discuss the details of each condition and how they are interlinked.
The connection between CVDs and diabetes
Diabetes tremendously increases the risk of heart disease, making people with diabetes twice as likely to develop heart problems compared to those without it.
The link between diabetes and heart disease comes from the negative effects of high blood sugar on blood vessels.
Over time, high glucose levels can cause the walls of arteries to thicken and harden, which is a condition called atherosclerosis.
This buildup of plaque can limit blood flow to the heart and brain and then raise the risk of heart attacks and strokes.
Additionally, people with diabetes often face other risk factors for CVD, like increased blood pressure and high cholesterol, which can make the situation worse.
These issues can combine and speed up the development of atherosclerosis and increase the chance of heart-related problems.
Heart complications and diabetes
Coronary artery disease (CAD):
Diabetes greatly raises the risk of coronary artery disease (CAD), which happens when the coronary arteries become narrow or blocked because of plaque buildup.
CAD is the leading cause of death in both type 1 and type 2 diabetes mellitus [ref]. High serum sugar levels can harm blood vessels and promote atherosclerosis, leading to reduced blood flow to the heart.
People with diabetes are more likely to have other risk factors, such as high blood pressure and high cholesterol, which further exacerbate the risk of CAD.
Stroke:
Diabetes is found in about 23% to 53% of people who have had a stroke [ref]. It is more common in those with ischemic stroke (33%) compared to hemorrhagic stroke (26%).
Additionally, people with diabetes are at a greater risk of having another episode than those without diabetes [ref]. This is also due to high blood pressure, which can cause the blood vessels to explode or be blocked.
Peripheral Artery Disease (PAD):
In hospital studies, PAD is two to seven times more common in people with diabetes compared to those without it. A national survey also found that PAD is twice as common in people with diabetes than in the general population [ref].
Heart failure:
Up to 22% of people with diabetes also have heart failure, with rates going higher in chronic cases (25%) and reaching up to 40% in sudden, severe cases of heart failure [ref].
This is because diabetes can weaken the heart muscles, damage nerves, and blood vessels, and impair its ability to pump blood all over the body.
Aortic aneurysm:
Experts are not sure whether the link between diabetes and aortic aneurysm (AA) increases or decreases the risks.
Some studies suggest that diabetes could lead to aortic aneurysm by being a major risk factor for atherosclerosis which is directly linked to AA [ref].
However, research has also suggested that people with diabetes might actually have a lower chance of developing certain types of aneurysms, like abdominal (AAA) and thoracic (TAA) aortic aneurysms.
They may also experience slower aneurysm growth, fewer ruptures, and a lower risk of death due to aneurysms [ref].
Prevention strategies:
Control of blood sugar levels
High blood sugar can harm blood vessels over time, raising the risk of heart disease. It is better to monitor blood sugar regularly and try to keep it within a healthy range.
Usually, the goal is to keep HbA1c levels below 7%, though personal targets might differ. Reaching this target often requires a mix of medication, like insulin or oral diabetes pills, and lifestyle changes, such as picking foods with a lower glycemic index.
Healthy eating and nutritional balance
Eating a proper diet plays a big role in managing diabetes and lowering heart disease risk. It is suggested to include foods high in fiber, whole grains, proteins, or healthy fats.
Excluding saturated and trans fats can help lower LDL cholesterol, which is good for the heart. Omega-3 fats, found in fish, flaxseeds, as well as walnuts, are also beneficial for heart health. For people with diabetes, limiting sugary and processed foods is a must.
Blood pressure management
High blood pressure frequently affects individuals with diabetes, adding to their cardiovascular disease risk.
Dietary modifications, regular exercise, stress management, and prescribed medications are great ways to get your BP under control. Keep your BP under 140/90 mmHg and try the DASH diet, which helps with this cause.
Cholesterol control
People with diabetes frequently experience unusual cholesterol levels, increasing their risk for cardiovascular disease.
Regular lipid profile monitoring can be good for the early detection of any changes. Medications like statins are commonly used to control cholesterol, particularly for those with other heart disease risk factors.
Moreover, lifestyle adjustments, such as including healthy fats from olive oil, nuts, and avocados, are better.
Smoking cessation
Smoking significantly raises the risk of cardiovascular complications in diabetics. It harms blood vessels & raises blood pressure and heart rate, leading to a risk of plaque buildup in arteries.
Quitting smoking is one of the most impactful actions to improve heart health and overall well-being in people with diabetes.
Weight management
Excess weight, particularly abdominal fat, is linked to insulin resistance, high BP, and cholesterol abnormalities and this is why maintaining a healthy weight is important for reducing CVD risk in diabetics.
Reducing even 5-10% of body weight can improve blood sugar control, lower blood pressure, and positively affect cholesterol levels.
