Diet and exercise may go a long way toward helping reduce the risk of cardiovascular disease associated with type 2 diabetes, but your physician may also want to recommend medication to help control blood glucose levels, cholesterol levels, and blood pressure. Medication could include insulin or oral dosages or a combination, as well as separate medications to address elevated blood pressure and/or cholesterol levels.

“Let’s not forget that things like diet, exercise, and weight loss will also help both improve your blood glucose levels but also independently improve your cardiovascular risk,” Dr. Saliaris said. Numerous studies show that with “plenty of diet and exercise those blood sugar levels get better, cholesterol levels get better, high blood pressure improves, and overall cardiovascular risk improves,” he said.

In addition, making sure that you’re fit and lean would be ideal, Dr. Saliaris said. Avoiding foods that would lead to obesity and maintaining a healthy weight are ideal ways to reduce the risk of heart disease associated with type 2 diabetes. “And, of course, remaining as physically active as you can. If you’re not physically active, then all of these things get worse. And, the more physically active you can be, usually the better you do.”

A lack of physical activity is a major risk factor for insulin resistance and cardiovascular disease that can be easily and readily modified.

It's likely that any type of moderate and/or vigorous intensity, whether sports, household work, gardening, or work-related physical activity is similarly beneficial. For overall cardiovascular health, the American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity at least five days per week for a total of 150 minutes.

Add at least two days each week of moderate to high-intensity muscle-strengthening activity to your routine. Aerobic activity is not enough, Dr. Saliaris said. “But also keeping your muscles strong, strengthening your core, strengthening your back muscles, all these muscles, is a good thing as well, and [remember] to stretch.” By managing risk factors, patients with diabetes may avoid or delay the development of heart and blood vessel disease.

Whether you have type 2 diabetes or not, smoking puts individuals at higher risk for heart disease and stroke. “Cigarette smoking is bad for anyone, but it’s particularly bad for patients who are diabetic,” Dr. Saliaris said. Smoking decreases your tolerance for physical activity and increases the tendency for blood to clot. It also decreases HDL (good) cholesterol.

Before you begin aspirin therapy, consult with your physician. He or she may recommend a low-dose aspirin regimen to help reduce your risk for heart attack and strokes. Aspirin "thins" the blood and helps prevent blood clots from forming — clots that can block blood flow through arteries, especially when those arteries are already narrowed by a buildup of plaque. Type 2 diabetes makes your blood somewhat more likely to clot, Dr. Saliaris said.

Stress can impact everyone differently. It can drain your energy level, rob you of sleep, cause everything from headaches to stomach aches, and lead to excessive drinking and overeating. All of these conditions can lead to an increased risk of cardiovascular disease.

Find a physician or a team of physicians who can keep close watch on your numbers. These include blood pressure, cholesterol, and weight. Your doctors can set you up with a treatment plan that can help minimize risk factors. Know your family history and share that with your care provider. Find someone you trust and can speak with candidly. Adhere to the plan prescribed.