Types of Heart Disease More Common in Diabetics

Cardiovascular disease, or CVD, refers to diseases that affect your heart and/or blood vessels. The blood vessels are part of your vascular system, or circulatory system. When someone with diabetes has cardiovascular disease, it is diabetic cardiovascular disease. CVD is an umbrella term for other heart diseases or conditions, such as coronary artery disease (CAD), angina, and heart attacks. Other conditions include cardiomyopathy, heart failure, atrial fibrillation, and peripheral artery disease.

Coronary artery disease is a condition in which the heart muscle (myocardium) is not receiving enough freshly oxygenated blood from the vessels—the coronary arteries—that supply it. This is caused by atherosclerosis, or hardening of the arteries. Atherosclerosis occurs when your arterial walls become hard and narrowed from plaque buildup. Poorly controlled blood glucose makes this more likely to occur. As your artery narrows, it becomes more difficult for the blood to flow through effectively, depriving your heart of necessary oxygen and nutrients. The blockage can grow to block the artery completely, or a piece of plaque can break off and travel through your bloodstream to your heart, causing damage.

A heart attack occurs when there is temporary or permanent damage to the heart tissue because of the lack of adequate blood flow to the heart. Called myocardial infarctions or MIs, heart attacks can be silent among people with diabetes. Neuropathy in the blood vessels can make it so you don’t feel angina, a painful warning sign of an impending heart attack, or pain from the actual heart attack. Many people with diabetes only learn they had a heart attack when they undergo testing for screening or another issue.

The term heart failure may give you the impression that your heart stops altogether, but that’s not the case. Heart failure means your heart is not pumping as well as it needs to be and blood is circulating more slowly than usual. This puts extra pressure on your heart as your body tries to make it work harder. The muscle may become stiff or thicken, making it even more difficult to pump effectively. Heart failure is usually caused by coronary artery disease or high blood pressure (hypertension). Someone with heart failure may feel short of breath, fatigued, or swelling in the abdomen or legs, known as edema.

Cardiomyopathy is another umbrella term used to describe diseases of the heart muscle itself. People with cardiomyopathy have an enlarged heart and the tissue has become thicker than normal and rigid. This makes it harder for the heart to pump effectively and weakens it.

Diabetes is a strong risk factor for atrial fibrillation (afib). Researchers know that glucose and insulin abnormalities have an effect on the heart muscle and can lead to afib, but the exact relationship between diabetes and afib is not known. People with afib who have diabetes also tend to have worse afib symptoms compared to afib patients without diabetes.

Living with diabetes includes watching for complications, such as heart disease. You can reduce your risk of developing diabetic cardiovascular disease and other vascular conditions by closely following your diabetes treatment plan and regularly following up with your doctor or diabetes team. Tell your doctor if you are not feeling well or have shortness of breath or other heart-related symptoms. If you are having signs of a heart attack (chest pain, sweating, lightheadedness, nausea and vomiting), call 911 immediately for emergency medical help.