Diabetes and Heart Disease: Key Facts You Must Know

Here's how to stay heart-healthy if you have diabetes.

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Adults with diabetes are nearly two to four times more likely to die from heart disease than those without diabetes, according to the American Heart Association (AHA)—but complications are not inevitable. By learning your risk factors, knowing the red-flag signs and symptoms, and making healthy lifestyle changes, you can take control and significantly decrease your risk of heart disease if you have diabetes.

Why Is Heart Disease Risk Higher in People with Diabetes?

Over time, high blood sugar can damage the nerves and blood vessels that supply blood to the heart. What’s more, people with diabetes can often have other conditions that contribute to heart disease risk, like high blood pressure, unhealthy cholesterol levels, or obesity.

What Heart Disease Symptoms Should You Look Out For?

Pay close attention to how you feel especially when you’re physically active. If you have shortness of breath, fatigue, nausea, or pain in the chest, don’t take it lightly. “People with diabetes don’t perceive pain the same way that other people do, so it might come on as something they may think is heartburn or they just don’t feel right in their chest,” says Minisha Sood, MD, an endocrinologist in New York City. If you have diabetes, it’s never too early to raise the concern about heart disease risk with your doctor. “If you’re having symptoms and you’re not sure what they are, don’t minimize them. Get the attention that you need,” says Dr. Sood.

What Can I Do to Decrease My Risk of Heart Disease?

The AHA considers diabetes to be one of the major controllable risk factors for cardiovascular disease, alongside obesity, high blood pressure, physical inactivity, high cholesterol, and smoking. Here’s what you can do lower your risk and lead a heart-healthy life.

Get checked. “All diabetics should have some degree of cardiovascular screening, says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health in New York City. This includes having your blood pressure and cholesterol checked, and possibly getting an EKG or a stress test if your doctor recommends it.

Ask your doctor about medication. If you’re over 40 years of age, regardless of your cholesterol level, Chaudhry recommends taking cholesterol-lowering medication. There may be other drugs, such as blood pressure medications or aspirin, that your doctor may advise you take as well.

Know your diabetes ABCs. Keeping your numbers in check can help keep your heart and blood vessels healthy. (Remember, these are general goals for most people, so check with your doctor to learn your individual goal.)

  • A is for A1C test. This test shows your average blood glucose level over the past 3 months and should be below 7% for people with diabetes.
  • B is for blood pressure.  Most people with diabetes should aim for a blood pressure reading below 120/80 mmHg.
  • C is for cholesterol. The American Diabetes Association (ADA) and the AHA recommend an LDL cholesterol goal of less than 100 mg/dl in all adults with diabetes. People who already have heart disease should aim for less than 70 mg/dl.


Maintain a healthy lifestyle.

  • If you smoke, quit. A smoker’s risk of developing heart disease is much higher than that of nonsmokers, whether they have diabetes or not.
  • Get active. The AHA recommends at least 30 minutes of moderate-intensity exercise (like brisk walking) at least 5 days per week, or 25 minutes of vigorous aerobic activity (like jogging) at least 3 days per week.
  • Eat well. Nutrition is one of your greatest weapons against heart disease and diabetes. Aim to fill your diet with mostly vegetables, fruits, and whole grains and low-fat dairy, and limit your intake of sweets, trans fats, and red meats.