How diabetes affects the heart
Q: I am 42 and recently was diagnosed with diabetes. My doctor said I could manage the condition with diet and exercise for now but suggested I follow up with a cardiologist. As far as I know, my heart is fine. What is the connection between diabetes and heart health?
A: While many may not realize it, having diabetes comes with a higher risk for heart disease.
Research has shown that people with Type 2 diabetes are up to four times more likely than the general population to die from cardiovascular causes. You can proactively take steps to reduce your future heart disease risk rather than by only managing blood sugar levels.
Diabetes can damage blood vessels and make the heart muscle stiffer. This eventually leads to problems with fluid retention and heart failure.
People with diabetes also have higher risk of premature accelerated coronary artery disease. This means that compared to those patients who do not have diabetes, the walls of the arteries have more fatty deposits and begin to harden earlier and without many warnings, making treatment difficult and causing the condition to progress faster. Subsequently, people with diabetes have an increased risk of recurrent heart attacks and scarring of the heart muscle, which increases the risk of sudden cardiac death. After a heart attack, the heart muscle does not heal as well as in people who do not have diabetes.
Due to nerve damage caused by diabetes, patients may not feel the chest pain or other types of chest discomfort that may signal something is wrong with the heart, so heart disease may not be detected until it is advanced. They also may suffer “silent heart attacks” because of the lack of warning signs.
Ongoing research also shows strong evidence that weight loss can reverse diabetes in some patients and that lowering blood pressure with drugs known as angiotensin-converting enzyme, or ACE, inhibitors and angiotensin II receptor blockers can reduce the risk of developing diabetes.
Positive lifestyle changes, such as quitting smoking, losing weight, exercising more, following a healthier diet and controlling blood pressure all can contribute to better diabetes control and heart health. Studies have shown that by achieving control of these cardiovascular risk factors, people prolong their lives by an average of eight years.
Fortunately, the recommendations for self-management behaviors generally align for the two conditions. This can make teaching self-care skills a bit easier for clinicians managing both diseases.
The recent development of cardiac imaging techniques, such as advanced echocardiography, cardiac CT and cardiac MRI, brings hope that medical professionals will be able to detect diabetic heart disease earlier. Thanks to those innovative imaging techniques, it’s understood that heart disease in people with diabetes progresses rapidly if not managed with well-established preventive treatments.
Ongoing research is using advanced medical imaging to study why the hearts of people with diabetes suffer more extensive injury after heart attacks and why those with diabetes develop heart failure more often than people with normal glucose control. Work is underway to review data to identify people with diabetes who may respond better to certain treatments.
The goal is to offer people with diabetes personalized plans to manage their heart health risk.
Heart disease and diabetes are chronic conditions that in most cases cannot be cured, but thanks to new therapeutic options, your risk of developing heart problems may be reduced. With proper guidance from your diabetes care team and heart health experts, you can go on to have a productive and more healthy quality of life.