The prevalence of diabetes calls for some heart-to-heart

There is a clear relationship between diabetes and heart disease. According to the American Heart Association, heart disease and stroke are the No. 1 causes of death and disability among people with type 2 diabetes.  

The good news is diabetes is a preventable and controllable disease. Understanding how diabetes affects your heart health is the first step in taking action to reduce your risk of cardiovascular complications. 


Diabetes 101  

The two main types of diabetes are type 1 and type 2.  

Type 1 diabetes occurs when the pancreas makes little or no insulin. Without insulin, the body is unable to take glucose (blood sugar) it gets from food into cells to fuel the body.  

It is sometimes referred to as “juvenile diabetes” because it is often diagnosed in children or young adults. People with type 1 diabetes must take daily injections of insulin to survive.  

Type 2 diabetes is the most common form of diabetes. It develops while the pancreas is still producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. Gradually insulin production decreases and blood sugar levels begin to rise causing diabetes to develop.  

Historically, type 2 diabetes is diagnosed in middle aged adults, however, it is now occurring in adolescents and young adults at a disturbing rate due in part to the rising obesity epidemic.  

The actual cause of type 2 diabetes is unclear, however, both genetics and lifestyle or environmental factors are believed to be key players in its development.  

Risk factors for type 2 diabetes include people with impaired glucose tolerance and impaired fasting glucose, obesity (especially if weight is centred around the stomach often called central obesity), age (over 45 years), physical inactivity, high blood pressure, abnormal cholesterol levels, and family history of diabetes or cardiovascular disease.  

Additional risk factors for women include gestational diabetes during pregnancy, giving birth to at least one baby weighing more than 9 pounds, and polycystic ovary disease. 


Diabetic heart disease  

The term “diabetic heart disease” refers to heart disease that develops in people who have diabetes.  

Type 1 or type 2 diabetics can develop diabetic heart disease. Research has shown when combined with other risk factors – such as high blood pressure, high blood cholesterol, lack of physical activity, obesity, and smoking – harmful physical changes occur in the heart.  

These changes can damage the heart’s structure and function. More importantly, in the early stages of diabetes, insulin resistance is related to fatty build-up in the arteries of the heart (atherosclerosis) and blood vessel damage even before diabetes is diagnosed. 


Take action 

If you are a diabetic or if someone close to you is, taking action now can prevent or delay heart disease. Adopting a healthy lifestyle should be part of a lifelong approach.  

Small, yet powerful changes can help control multiple risk factors. For example, daily physical activity has been shown to lower your blood pressure, control your sugar level, reduce stress, and help control weight.  

Other important actions steps include following a healthy diet, maintaining a healthy weight and waist circumference, and quitting smoking.  

Following the treatment plan your doctor recommends for you is crucial. Diabetics need good blood sugar control. Ask your doctor about ways to best control your blood sugar. Talk with them if you’re having trouble taking your medications or if you are having any side effects.  

Take time to discuss your risk of diabetic heart disease. Know your other important health numbers like cholesterol and blood pressure. Utilise other members of your health care team. See a dietician for help learning about or following a healthy diet that helps control blood sugar. Talk with your pharmacist to learn more about your medications and how they work. 

High blood pressure: Take action now for a healthier heart and healthier life. 

High blood cholesterol: Diabetes tends to lower “good” cholesterol levels and raise triglyceride and “bad” cholesterol levels, which increases the risk for heart disease and stroke. 

Lack of physical activity: Being inactive can worsen other risk factors for heart disease such as high cholesterol, high blood pressure, diabetes, and overweight or obesity. 

Obesity: Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Obesity and insulin resistance have also been linked with other risk factors, including high blood pressure and high cholesterol. 

Smoking: Smoking raises blood glucose levels. Smoking also aggravates other risk factors such as increasing cholesterol levels and raising blood pressure. Smoking can also reduce the amount of vital oxygen that reaches the heart muscle. 


Jodie Kelley, RN, is an education and programme coordinator based in Cayman Islands. 

Understanding how diabetes affects your heart health is the first step in taking action to reduce your risk of cardiovascular complications. 

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