Key takeaways

  • Chronically high blood sugar levels associated with diabetes can increase heart disease risk by damaging your blood vessels and contributing to plaque buildup.
  • Diabetes and heart disease also share some risk factors, such as high blood pressure and high cholesterol.
  • Prevention and treatment strategies for both conditions are often similar and can include diet changes, physical activity, and medication.

Learning that diabetes increases your risk of heart disease may feel overwhelming, but understanding this connection can help you better protect your health.

Diabetes doesn’t directly cause heart disease, but it can significantly increase your risk.

The American Heart Association (AHA) reports that people living with diabetes have a higher risk of cardiovascular conditions, including:

In a 2018 systematic literature review, around 32% of the 4.5 million adults with type 2 diabetes also had cardiovascular disease. The review also found that cardiovascular disease was a significant cause of death among people with diabetes during the study period.

People with diabetes are also more likely to have heart disease risk factors, including:

A 2023 research review notes that most studies on cardiovascular disease and diabetes focus on type 2 diabetes.

That doesn’t mean people with type 1 diabetes have a lower risk of heart disease. Rather, it may be because type 2 diabetes is more common, accounting for the vast majority of diabetes cases globally.

Type 1 diabetes and heart health

Research from 2019 indicates that at least 50% of women and 70% of men with type 1 diabetes experience coronary artery calcification by the age of 45. That is when calcium builds up in the heart’s main arteries and blocks the blood’s passage.

The researchers speculated it could be linked with long-term high blood sugar levels or kidney damage, starting at a young age. These factors can increase blood pressure, cholesterol levels, and inflammation, all of which can harm heart health.

Researchers are still exploring why diabetes increases heart disease risk. The following are some likely contributing factors.

Higher blood sugar levels and A1C

Diabetes affects how well your body regulates blood sugar, also called glucose. Chronically high blood sugar levels can harm the inner lining of your blood vessels.

It can also contribute to the development of atherosclerosis, a condition where your blood vessels get harder and narrower due to plaque buildup. This increases the risk of complications like stroke and heart attack.

A hemoglobin A1C, or HbA1C, test measures your average blood glucose over the past 2 to 3 months. If you have diabetes, it can give insight into managing your condition.

A 2017 systematic review and meta-analysis found that higher A1C levels are linked with increased cardiovascular risk. This is another indication that high blood sugar may affect heart health.

High blood pressure

Many people with diabetes also have high blood pressure, or hypertension.

Hypertension is a significant risk factor for heart disease. For example, it can:

  • damage blood vessels
  • promote inflammation
  • contribute to atherosclerosis

Hypertension may also increase the risk of complications like heart attack or heart failure.

High cholesterol

High cholesterol is another key contributor to heart disease, especially with diabetes.

Many people with type 2 diabetes develop dyslipidemia, a cholesterol condition that involves:

  • High LDL: Low-density lipoprotein (LDL) is a bad type of cholesterol that contributes to atherosclerosis.
  • Low HDL: High-density lipoprotein (HDL) is a good type of cholesterol that helps remove excess cholesterol from your blood.
  • High triglycerides: Triglycerides store energy in your blood. High levels can be harmful to heart health when paired with high LDL and low HDL.

Obesity

Obesity is a significant risk factor for diabetes and heart disease. It can increase the risk of cardiovascular issues, contributing to:

  • insulin resistance
  • higher blood pressure
  • atypical cholesterol levels
  • increased inflammation
  • blood vessel damage

Low physical activity levels

A less active lifestyle can compound the risk factors associated with heart disease and diabetes.

According to research from 2020, not getting enough physical activity may contribute to:

  • weight gain
  • difficulty regulating blood sugar levels
  • hypertension
  • high cholesterol

Smoking

Smoking is a significant risk factor for both heart disease and diabetes.

In people with diabetes, smoking can worsen the damage to blood vessels that high blood sugar levels cause. It can also increase the risk of heart attack, stroke, and other heart health complications.

If you currently smoke, talk with your healthcare professional about stopping. They may be able to recommend a smoking cessation program or other alternatives to help you quit.

Heart disease encompasses different conditions, such as blockage of the arteries, irregular heartbeat, and heart valve damage.

Symptoms of heart conditions can either be intense and sudden, or subtle and easy to overlook. For instance, a heart attack can cause sharp, shooting pains, while high blood pressure typically has no symptoms at all.

Symptoms of heart conditions can include:

  • chest pain or discomfort
  • shortness of breath
  • nausea or vomiting
  • fatigue or weakness
  • pain, numbness, or coldness in the legs or arms
  • lightheadedness or dizziness
  • swelling in the legs, ankles, or feet
  • generally feeling unwell
  • confusion
  • vision changes
  • fainting or unconsciousness
  • irregular heartbeats

If you have diabetes, there are proactive steps you can take to keep your heart healthy, including:

This includes lifestyle factors, such as:

  • Following a nutritious diet: A nutritious diet can support a moderate weight and better blood sugar management. Prioritize fruits, vegetables, whole grains, lean proteins, fiber, and healthy fats. Healthful eating plans include the Mediterranean and DASH diets.
  • Exercising regularly: Regular physical activity can help you manage your weight, improve insulin sensitivity, and strengthen your heart. The AHA and other organizations typically recommend at least 150 to 300 minutes of moderate intensity aerobic exercise each week. It also recommends muscle strengthening exercises at least twice weekly.
  • Quitting smoking if you smoke: Quitting smoking can significantly improve heart and overall health.

Besides lifestyle changes, your healthcare team may recommend taking medications for diabetes or heart conditions.

Start with small steps

Small, manageable lifestyle adjustments can compound over time and may make a big difference in protecting your heart health and managing diabetes.

Ready to dive deeper into these conditions and learn what these adjustments can look like? Try Healthline’s 5-minute, bite-size lessons for type 2 diabetes and heart health.

Whether or not you have diabetes, treatment for heart disease usually involves the following:

  • Lifestyle changes: Following a balanced eating plan, getting regular physical activity, and avoiding smoking can all be part of prevention and treatment plans for heart disease.
  • Medications: Depending on your condition, your healthcare professional may prescribe medications. Options include statins for high cholesterol or ACE inhibitors for high blood pressure. They may also prescribe medications to manage your blood sugar levels, such as insulin or SGLT2 inhibitors.

In some cases, more intensive treatments like surgery may be necessary to manage issues like blockages in your arteries.

Yes, other diabetes complications can indirectly affect your heart health. These complications include:

  • Diabetic nephropathy: This is a type of kidney disease. It may increase your risk of heart disease by causing fluid buildup and high blood pressure.
  • Diabetic retinopathy: Although it primarily affects your eyes, retinopathy can also affect your blood vessels.
  • Diabetic cardiomyopathy: Changes in your heart structure and function of your heart muscle can occur, independent of other heart conditions.
  • Peripheral artery disease (PAD): Diabetes increases the risk of PAD, where narrowed arteries reduce blood flow to the limbs. PAD increases heart attack and stroke risk.

If you experience any symptoms of heart disease — such as chest pain, shortness of breath, or dizziness — seek immediate medical attention. These could indicate life threatening conditions like a heart attack or stroke.

Connect with an expert

A good first step for non-emergency prevention and treatment advice is speaking with a healthcare professional, such as an endocrinologist. They can assess your current health and recommend strategies for improving your heart health and managing your diabetes.

Find an endocrinologist in your area today.

Many people with diabetes also develop heart conditions.

Managing your blood sugar, blood pressure, and cholesterol levels and making lifestyle changes can reduce your risk of cardiovascular issues.

Working with a healthcare team can also help you better manage your diabetes, reduce your risk of heart disease, and improve your quality of life.