What's the Connection Between Diabetes and Heart Disease?

If you've recently been diagnosed with diabetes or have been struggling to keep your blood sugar regulated, it can be scary to imagine how other parts of your body might be affected, especially your heart. According to the American Heart Association, individuals with diabetes are two times more likely to die from cardiovascular disease (CVD) than people without diabetes, and the longer you live with diabetes, the higher your CVD risk. But what exactly drives this connection, and if you have diabetes, what can you do to help protect your heart?

Diabetes is a condition in which the body's glucose, or blood sugar, levels are higher than normal (called hypoglycemia). High glucose levels cause blood vessels to contract more than normal, which can increase blood pressure and reduce blood flow rate. Additionally, increased glucose and fat in the blood results in weakened and stressed blood vessels. Over time, fatty material called plaque can build up along weakened blood vessel walls, hardening them and limiting the flow of oxygen-rich blood to the heart. This is a condition known as atherosclerosis. In response, the body's immune system will send white blood cells to consume the plaque particles and wall them off from the flowing blood. If the plaque ruptures, the walled off contents can form blood clots, which can completely block blood flow to the heart (heart attack) or to the brain (stroke).

Diabetes is categorized as Type 1 (in which the body does not produce insulin) or Type 2 (in which the body doesn't respond to insulin as well as it should). While both types of diabetes are associated with heart disease risk, people with Type 2 diabetes may have other conditions that increase the risk of heart disease and stroke even when glucose levels are being managed. That's because insulin resistance has been associated with several other cardiovascular disease risk factors:

• High blood pressure —When patients have both diabetes and high blood pressure, their risk for cardiovascular disease doubles.
• High cholesterol — With insulin resistance, the body often will produce more insulin to compensate. High insulin levels can raise the amount of low-density lipoproteins (LDLs, or "bad" cholesterol) and lower the amount of high-density lipoproteins (HDLs, or "good" cholesterol).
• Increased triglycerides — People with Type 2 diabetes often have increased tryglicerides regardless of blood sugar control. High triglycerides combined with high cholesterol can increase the likelihood that fatty, artery-clogging plaque will develop.
• Obesity — Excess body fat, especially in the abdomen, causes low levels of inflammation, which can contribute to increased insulin resistance.
• Lack of physical activity — Exercise helps the body use insulin properly, which can help reduce chronic inflammation. Without exercise, the body's resistance to insulin can increase.

When it comes to managing diabetes and the other CVD risk factors that can develop, working with a physician to regularly monitor your health is extremely important. Your doctor can recommend lifestyle changes that might help manage your condition and discuss a plan of care that will address changes in your health as they occur.

Interested in learning more about the specific risk factors that might be putting you at risk for heart disease? Take our free heart health assessment to receive a personalized analysis of your heart disease risk.