Heart Disease Prevention for People With Diabetes

Patient Expert
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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?


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.


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.


  1. Manage your blood sugar intensively

Elevated blood sugar is associated with an increased risk of cardiovascular disease in people with diabetes. AHA suggests that you can reduce your risk of heart disease by keeping your hemoglobin A1C (HbA1C) levels:

  • less than 7.0 percent for adults
  • less than 7.5 percent for teenagers aged 13 to 19
  • less than 8.0 percent for ages 6-12
  • less than 8.5 percent for children under 6


  1. 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.


  1. 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.


  1. 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.


  1. 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.


  1. 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.


  1. 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.


  1. 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.