Diabetes and Cardiovascular Disease: Whats the Link?

Adapted from the National Diabetes Education Program by Amy Scholten, MPH Cardiovascular disease (CVD) is the leading complication and cause of premature death among people with diabetes. Unfortunately, many people with diabetes do not understand the risk of cardiovascular disease or what they can do to help prevent it. Diabetes is a disorder in which the body does not make insulin, does not make enough insulin, or does not properly use the insulin it produces (insulin resistance). Insulin helps the body convert food into energy. Without insulin, glucose (sugar) from food cannot enter cells. Glucose builds up in the blood and body tissues become starved for energy. Long-term, high blood sugar levels can damage the arteries, kidneys, eyes, nerves, and other tissues. Risk of Cardiovascular Disease In people with diabetes, high blood glucose levels are associated with the development of atherosclerosis. This is a condition in which fatty deposits (plaque) damage the lining of the arteries, causing them to narrow and harden. Atherosclerosis, the main cause of CVD, interferes with blood flowultimately leading to several manifestations of CVD including: Coronary heart disease and heart attacks Cerebrovascular disease and strokePeripheral artery disease and claudication (pain with walking)Cardiomyopathy and congestive heart failure According to the National Diabetes Education Program, the link between diabetes and CVD is significant. For example:

Adults with diabetes are 2-4 times more likely to have CVD than people without diabetes. Middle-aged people with type 2 diabetes have the same risk for a heart attack as people without diabetes who have already had a heart attack. Heart attacks occur at an earlier age in people with diabetes.People with diabetes are more likely to die from a heart attack. Why Risk Is Increased People with type 2 diabetes often have an increased risk of CVD for the following reasons: Their platelets have an added tendency to clump together leading to clotting problems and poor blood flow. They have higher rates of high blood pressure and obesity. They tend to have unfavorable lipid profiles, particularly increased LDL or bad cholesterol, low levels of HDL or good cholesterol, and increased levels of triglycerides. People with diabetes who smoke double their risk of CVD. High-risk GroupsThose with the highest risk for diabetes and its CVD complications include:People With a Family History of DiabetesRisk increases for those who have a first-degree relative with type 2 diabetes.

People with diabetes can take the following steps to help reduce their risk of CVD: Get involved in treatment decisions with your healthcare teamSet lifestyle goalsBecome well-educated about diabetes and CVDBe actively involved in the management of your diseaseDiligently control your blood glucose, cholesterol, and blood pressure with and without medicationsAsk about aspirin therapy for CVD preventionQuit smoking, if you smoke RESOURCES: American Diabetes Associationhttp://www.diabetes.org National Diabetes Education Programhttp://www.ndep.nih.gov National Institute of Diabetes and Digestive and Kidney Diseaseshttp://www.niddk.nih.gov CANADIAN RESOURCES: Canadian Diabetes Associationhttp://www.diabetes.ca/ Heart and Stroke Foundation of Canadahttp://ww2.heartandstroke.ca References: National Diabetes Education Program website. Available at: http://www.ndep.nih.gov. National Institute of Diabetes and Digestive and Kidney Diseases. Available at: http://www.niddk.nih.gov. Last reviewed May 2008 by Craig Clark, DO, FACC, FAHA, FASEPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.