Heart Disease Prevention for People With Diabetes

by Mary Shomon Patient Advocate

If you have diabetes and are confused about how to lower your risk of heart disease, you’re not alone. Several sets of guidelines on the management of heart disease in people with diabetes have been released over the past decade. Some offer general recommendations that apply to people with type 1 or type 2 diabetes. Others have specific advice depending on the type you have. What do you need to know about how to lower your risk of heart disease?

doctor with statistics

Stats on Diabetes and CVD

To start, you need to know that both type 1 and type 2 diabetes can raise your risk for heart disease, also known as cardiovascular disease (CVD). These mortality statistics from the American Heart Association tell the story:

  • At least 68 percent of people over age 65 who have diabetes die from some form of heart disease.
  • Around 16 percent of people over 65 who have diabetes die of stroke.
  • Adults with diabetes are two to four times more likely to die from heart disease than adults who don’t have diabetes.
Woman checking her pulse

Take Action to Reduce Risks

When you have diabetes, it's especially crucial for you to do what you can to reduce your cardiovascular disease risk.

Guidelines released by the American Heart Association (AHA) in 2015 recommend that people with diabetes reduce their risk of heart disease by taking the following actions to.

Monitoring blood glucose.

1. Manage Your Blood Sugar Intensively

The ADA suggests that you can reduce your risk of heart disease by keeping your hemoglobin A1C (HbA1C) levels within the following ranges:

  • <7% for non-pregnant adults
  • <6.5% for patients with short duration of diabetes, type 2 diabetes treated with lifestyle or metformin only, long life expectancy, or no notable cardiovascular disease
  • <8% for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes
Doctor checking a patient's blood pressure.

2. Lower Your Blood Pressure and Stroke Risk

High blood pressure increases your heart disease risk. The AHA recommends that your blood pressure stays below 130/80 mmHg. Effective ways to lower your blood pressure include taking prescription medications such as beta blockers and diuretics, keeping your salt intake to less than 2300 mg per day, supplementing with potassium, and getting regular exercise. Some experts also recommend that people with diabetes take a daily aspirin.

Statin pills.

3. Lower Your LDL Cholesterol

The goal is to keep your low-density lipoprotein (LDL) level lower than 100. Lowering LDL cholesterol involves dietary changes, regular exercise, and in some cases, prescription cholesterol-lowering drugs such as statins when necessary.

Woman measuring her waist.

4. Lose Weight, Especially From Your Waist

According to a 2016 study, losing 5 to 10 percent of your body weight can reduce your heart disease risk. You should also focus on reducing fat in your waist and belly area. According to the National Institutes of Health, for heart health benefit, your waist measurement should be less than 40 inches for men, and 35 inches for women.

Man running in a park.

5. Get Regular Exercise

Exercise is an essential part of reducing your risk of heart disease: The AHA recommends that you get at least 30 minutes of moderate-intensity aerobic activity at least 5 days per week, or at least 25 minutes of vigorous aerobic activity at least 3 days per week, for a total of 75 minutes. In addition, the AHA recommends that you engage in moderate-to high-intensity muscle-strengthening activity at least 2 days per week.

Healthy salad.

6. Make Dietary Changes

In general, to lower your heart disease risk, experts recommend changes to your diet, including:

  • Lowering your overall caloric intake
  • Monitoring and reducing your carbohydrate intake, especially simple and processed carbohydrates such as sugar, desserts, sugary drinks, low-fiber bread, low-fiber cereal, and wheat pasta
  • Switching to a more fruit- and vegetable-rich diet

Some specific diets that have proven to be effective in helping to reduce heart disease risk include the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet.

Crushed cigarette butt.

7. Stop Smoking

Smoking is a known risk factor for cardiovascular disease and is even more pronounced in people with diabetes. Experts recommend stopping smoking as an important part of any efforts to lower your risk of heart disease.

Coloring in an adult coloring book.

8. Manage Your Stress

Ongoing, unrelieved stress has adverse effects on your heart.To lessen your cardiovascular risk, you should avoid significant stressors whenever possible, and learn how to manage unavoidable or chronic stress. Experts recommend adopting a formal stress reduction practice such as meditation, breathwork, qi gong, tai chi, or a stress-busting activity like crafting or coloring.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.