Exploring the Relationship Between Diabetes and Heart Disease

Braden G. Barnett, MD

2021 Dec 21

11 min read

Heart disease is one of the most common and severe conditions that affect adults globally. It’s a real medical concern due to its many risk factors. Diabetes has been confirmed to be one of the significant causes of heart disease, and the correlation between the two conditions is very high.

According to credible CDC reports, people with diabetes are twice more likely to develop heart disease—and at a much younger age—than those who don’t have the condition. It’s, however, not doom and gloom for diabetics as the risk factors for heart disease can be effectively reduced and controlled with the right changes to lifestyle and eating habits.

Many heart disease and diabetes health professionals have continued to provide diabetics with expert tips and therapies for managing their condition and reducing the risk of heart disease. Apart from independent medical providers, national institutes such as the American Diabetes Association (ADA) and the American Heart Association (AHA) have continued to educate people with diabetes on how they can live healthily to reduce the risks of a heart attack.

What to Expect?

  • What Is Heart Disease?
  • Types of Heart Diseases
  • What Causes Heart Disease in People With Diabetes?
  • How People With Diabetes Can Detect Heart Disease Warning Signs
  • Important Lifestyle Changes to Manage Diabetes and Secure a Better Heart Health

What Is Heart Disease?

Heart disease is an umbrella term for all kinds of health complications that affect the heart. While it’s commonly confused with cardiovascular disease, they’re very different.

Cardiovascular disease comprises heart disease, blood vessels disease, and stroke. On the other hand, heart disease can happen for many reasons, but one of the major causes is diabetes.

Diabetes and heart failure are closely related, and most diagnoses of heart problems have been highly associated with people diagnosed with diabetes or high blood sugar.

According to data drawn on people with diabetes by the American Heart Association, 65% of diabetics are likely to die from heart attacks and other forms of heart disease and stroke. Also, while all people with diabetes have a higher chance of suffering from heart disease, the frequency is higher with those with type 2 diabetes.

Medical practitioners generally emphasize that patients diagnosed with type 2 diabetes manage their health and prevent other risk factors that could develop heart disease. This is logical since heart disease is the major cause of death for people with type 2 diabetes.

Types of Heart Diseases

Source: Johns Hopkins Medicine

Let’s examine the various forms of heart diseases and how they differ.


While many forms of heart issues are associated with diabetes, the commonest is coronary artery disease (CAD), also known as atherosclerosis. The disease develops when plaque builds up in the coronary arteries walls — the blood vessels that supply oxygen and blood to the heart.

The plaques that build up in the wall of the blood vessels are formed from cholesterol deposits. They force the arteries’ thinning and hardening, which subsequently decrease the rate at which blood flows to the heart. This hardening process is known as atherosclerosis.


While arrhythmias are not as popular as atherosclerosis, it’s also one heart disease that people with diabetes are susceptible to. This condition is characterized by an irregular heartbeat caused by structural alteration or damage.

The damage disrupts the heart’s electrical activity responsible for the heart’s rhythmic beats. At the early stage, arrhythmias may not seem like a serious problem. However, as it advances, it stops blood flow to the heart, leading to serious complications such as heart attack and death.

Heart Failure

Heart failure is one of the later stages of heart disease, and it’s a severe condition that could lead to death. Heart failure doesn’t mean that the heart has stopped beating. Instead, the heart becomes so weak that it can no longer pump blood as it should.

One of the common symptoms of this condition is fluid retention in the lungs, which leads to heavy and short gasps. Other symptoms include swelling in the legs, which results from fluid retention.

When diagnosed early, heart failure can be successfully managed. However, as it gets worse, treatment may relieve symptoms, stop more damage to the heart, and, at worst, delay the condition’s progression if curing is not possible.

Diabetes and heart failure often go together. For most people, diabetes is majorly the cause of death in patients. The reality, however, is that diabetes won’t lead to death if properly managed and blood sugar levels are kept at the optimal.

On the other hand, when there’s a lack of an early diagnosis and treatment, diabetes leads to other complications such as heart disease, stroke, and kidney disease. As heart disease advances, it leads to heart failure, which subsequently leads to death.

In summary, diabetes and heart failure are very different, and proper diagnoses will help a person with the former avoid the latter and lead a healthy life.

What Causes Heart Disease in People With Diabetes?

It’s clear that diabetes is a key risk factor for heart disease. However, which diabetes symptoms put you at risk of a cardiovascular disorder? We’ll gloss over these in the following sections. 

High Sugar Level

Diabetes and heart failure have an interesting relationship. As blood sugar levels rise over time, it could damage blood vessels and nerves controlling the heart.

Furthermore, having an unhealthy body weight doesn’t help reduce the risk of developing a heart condition as excessive fat levels cause a rise in blood glucose levels. Apart from high blood sugar causing diabetes, it also causes other diseases such as kidney disease.

High Blood Pressure

While high blood pressure (HBP) isn’t exactly a direct symptom of diabetes, people that suffer from the latter are likely to develop HBP due to poor psychological interaction with their condition. When this happens, they become more likely to develop heart disease.

High blood pressure causes an abnormal increase in blood flow through the arteries, easily damaging their walls and making them less functional. This alteration decreases the flow of blood and nutrients to the heart, increasing the risk of heart issues.

High LDL (“Bad”) Cholesterol

Low-density lipoproteins (LDL), also known as “bad” cholesterol, are a significant risk factor for coronary artery disease. Even for people that don’t have diabetes, high LDL generally increases their risk of developing heart problems. However, diabetics are extremely more likely to develop CAD due to high cholesterol consumption.

High Triglycerides Level

This is another type of cholesterol that’s not exactly LDL but also contributes as deposits that harden the arteries of coronary arteries. The major issue with high triglycerides is that it doesn’t have any visible symptoms until it’s at excessively high levels.

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Other factors that could also cause heart disease include:

  • Smoking
  • Lack of enough physical activity
  • Overweight and obesity
  • Consistent consumption of alcohol
  • The intake of meals that are high in trans-fat, saturated fat, and sodium
  • Genetic ties such as family
  • History or family members that have experienced diabetes before

How People With Diabetes Can Detect Heart Disease Warning Signs

Having diabetes can be hard on some people to the extent that they don’t pay attention to subtle growing changes caused by heart issues at their earliest stage. Others may not even bother about getting a customized diabetes management program and may interpret emerging heart degradation symptoms as normal.

Without proper diagnosis of a heart condition and other important risk factors, most people with diabetes may miss the warning signs of heart disease risks at the early stage. This is one of the reasons why continuous diagnoses and consultation with a medical professional are crucial.

This section outlines some warning signs of heart diseases that patients with diabetes should see as a red alert.

The Early Symptoms of Heart Disease and Heart Attack

According to the American Association of Diabetes, people with diabetes should be medically conscious of cardiovascular disorder-related symptoms. If a patient experience any three of these symptoms in a week, then they are likely dealing with a heart complication in its early stages:

  • Shortness of breath: Once breathing becomes difficult and seems to come in gasps, it could be an alert for heart complications
  • Feeling faint, dizzy, or fatigued
  • Excessive sweating that’s both unusual and unexplained
  • Pains in different parts of the body, including the shoulder, left arm, jaw, chest, throat, back, neck, and upper abdomen
  • Numbness and excessive weakness in arms and legs
  • Nausea

When any of these symptoms occur, a diabetic patient shouldn’t hesitate to call a doctor and have a thorough diagnosis. While these are early symptoms of heart disease and diabetes complications, they don’t outrightly mean that the patient has developed heart disease. This is why a diagnosis is necessary to identify the condition properly.

If more symptoms are diagnosed, such as the one below, it’s most likely heart disease.

  • Fullness — this might feel like indigestion or heartburn
  • Shortness of breath
  • Fainting

Important Lifestyle Changes to Manage Diabetes and Secure a Better Heart Health

Source: diaTribe

The link between diabetes and heart disease is glaring, with the former increasing the possibility of cardiovascular disease. Health professionals generally advise that patients with diabetes can reduce the risk of heart attacks with proper management of their health condition.

There are various ways to manage diabetes and heart attack-related conditions. The kind of treatment, therapy, or lifestyle changes prescribed will depend on whether the patient seeks to prevent or manage the heart disease following diagnosis.

Get a Diabetic Management Plan Set Up

The American Diabetes Association (ADA) explains that the best way to maintain great heart health is to effectively manage your diabetes health. Setting up a diabetes management plan is extremely important in helping you reduce the risk of developing heart disease and living a healthier life with little interference with your diabetic condition.

To set up an effective diabetic plan, people with diabetes will need their doctor to help them set up a customized control plan that helps manage their condition according to their personalities. They will know exactly how to test their blood glucose level and always ensure it’s within the appropriate range. Also, they need expertly prescribed insulin and medications to prevent the risk of any health complications.

A good diabetes plan also helps patients with the right exercise to help them reach and sustain an ideal healthy weight for their optimal health. Notably, physical activity helps control their blood sugar levels and slashes the risk of heart disease.

People with diabetes could try to get a minimum of 150 minutes of moderate-intensity physical activity (e.g., brisk walking) weekly.

Another important lifestyle change that diabetics can incorporate from their diabetes management plan is to keep their sugar level normal through dieting.

The type of food that a person with diabetes consumes is extremely important when they have diabetes. To reduce the risk of developing a heart condition, people with diabetes will need to reduce the amount of cholesterol that they consume in their meals.

Too much consumption of “bad” cholesterols (LDL) or triglycerides will lead to deposits forming plaques in the coronary arteries. This will lead to a blockage in the blood vessels and subsequently increase the risk of CAD and heart failure.

By cutting off “bad” cholesterol from their diet, people with diabetes can improve the health of their heart and blood vessels that ensure healthy blood flow. Patients should also ensure that they test for diabetes to help them live healthy lives.

Pro-Heart Disease Management Plan

The outlined management is for managing heart disease when diagnosed.

Follow a Healthy Diet

People with diabetes will need to eat more vegetables, fresh fruits, lean protein, and whole grains. They should also avoid or drastically reduce processed foods such as sweets and fast foods. Finally, they must avoid trans fat and drink more water often instead of sugary drinks and alcohol.

Manage the ABCs

A Getting a regular A1C test to monitor average blood sugar over 2–3 months and try to remain in the target range

B Ensuring Blood pressure doesn’t go above 140/90 mm Hg or your doctor’s recommended target

C — Managing Cholesterol levels

s — Quit Smoking or don’t commence at all

Manage Stress

Stress causes a rise in blood pressure and can make you stick to unhealthy behaviors that include overeating excessive alcohol intake or overeating.

Rather than focusing on bad habits for treatments, people with diabetes should pay a mental health counselor a visit, adopt meditation and deep breathing, and exercise. They can also seek support from family and friends.


Diabetes and heart disease are serious concerns, and knowing the exact way to manage them is of paramount importance. Managing diabetes and reducing heart risk requires that patients know exactly all the dos and don’ts of living heart-healthy.

While all the information in this article can help diabetics live healthier, adding our Klinio app to your diabetes management plan will make it significantly easier to plan your diet properly. Notably, our app lets patients know all the right meals they can take without increasing their risk of getting heart disease.

Written by

Braden G. Barnett, MD

Dr. Braden G. Barnett is an endocrinologist in Los Angeles, California and is affiliated with multiple hospitals in the area, including Keck Medical Center of USC and USC Norris Comprehensive Cancer Center. He received his medical degree from University of Southern California and has been in practice around 8 years. A skilled professional, Dr. Barnett holds certification from the American Board of Internal Medicine with a special focus on endocrinology, diabetes, and metabolism. He is also a recipient of several awards and honors.

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