Diabetes can increase your risk of heart disease and stroke and people with diabetes may develop heart disease 15 years earlier than those without diabetes.
For people with diabetes, the most common form of heart disease is coronary artery disease which develops when the arteries that supply the heart with blood become narrowed or blocked by fatty deposits. If the arteries that supply the brain become blocked, this may lead to a stroke.
High blood glucose (sugar) is one risk factor for heart attack or stroke, but people with diabetes often have several risk factors including:
- being overweight (especially if the excess fat is around the waist)
- little or no exercise
- high blood pressure and high cholesterol
- smoking
- family history of heart disease or stroke.
Reducing risk
People with diabetes can lower their risk of heart disease and stroke considerably by paying careful attention to all their risk factors. As well, if they work with their health-care team to achieve manageable targets, they can achieve good diabetes management. However, it must also be recognized that most diabetics will also require medications to reach their goals and protect their hearts and brains.
The ABCDEs of diabetes management to reduce heart attack and stroke risk:
A – A1C—Most people should aim for an A1C of seven per cent* or less by managing blood sugars well. A1C is a blood test that measures your average blood sugar level over the past 120 days.
B – Blood pressure—Your blood pressure should be less than 130/80* mmHg.
C – Cholesterol—The LDL (bad) cholesterol target is less than 2.0* mmol/L.
D – Drugs to protect against heart attack and stroke, such as:
- blood pressure pills (ACE inhibitors or ARBs)
- cholesterol-lowering pills (statins) which lower LDL (“bad”) cholesterol and other drugs that may be used to increase HDL (“good”) cholesterol and lower other blood fats such as triglycerides
- Aspirin, and prescription blood thinners may be prescribed to prevent the formation of blood clots that can cause strokes and lung embolisms.
E – Exercise & Eating—Regular physical activity and a healthy diet can help you achieve and maintain a healthy body weight. Limiting your intake of salt and alcohol can also help to protect your heart and brain.
S – Screening for complications—Ask your health-care team about tests for your heart, feet, kidneys, and eyes.
S – Smoking cessation—Stop smoking or seek help to quit.
S – Self management, stress, and other barriers—Set goals for yourself to reach your targets and live well with diabetes, such asmanaging stress effectively.
* Note that A1C targets for pregnant women, older adults and children 12 years of age and under are different. Both Diabetes Canada and Heart and Stroke are participating charities in Federated Health Charities and work to support those living with diabetes and heart disease to ensure they have all the support they need. To support them in this work, donate to Federated Health Charities today.
