Diabetes, a chronic disease that affects more than 30 million adults in the United States, causes your blood glucose (sugar) levels to be too high. Whether you have type 1 diabetes or type 2 diabetes, treatment focuses on keeping your blood glucose levels as close to normal as possible. This helps reduce the risk of damage to blood vessels throughout your body. Consistently high or fluctuating blood glucose levels can cause serious complications, including diabetic heart disease, or diabetic cardiovascular disease. Learn why this happens and what you can do to reduce your risk of developing diabetic cardiovascular disease. Types of Heart Problems Related to Diabetes Diabetes, particularly type 2 diabetes, is one of the risk factors for heart disease. It can also cause heart disease to begin earlier and be more severe compared to people without diabetes. And although diabetic heart disease occurs in both men and women, the risk is higher among women. Diabetic heart disease includes: Coronary artery disease (CAD). Coronary artery disease starts slowly and is ‘silent’—there are no symptoms at first. Diabetes can cause inflammation of the blood vessels and damage to the blood vessel walls. As the walls become damaged, fatty deposits (plaque) can stick to the wall surface. As fatty deposits accumulate, eventually there may be a blockage or a piece may break away and travel through the blood vessels to your heart, causing a heart attack. Diabetic cardiomyopathy. Cardiomyopathy is a condition where your heart muscle (myocardium) becomes enlarged or thick. It can also become rigid and less flexible. When this occurs, your heart rhythm becomes irregular and it can’t efficiently pump blood to the rest of your body. Cardiomyopathy caused by diabetes and not another issue, such as high blood pressure, is diabetic cardiomyopathy. Heart failure (congestive heart failure). Diabetic cardiomyopathy can lead to congestive heart failure, which is the inability of your heart to effectively pump blood. As the blood is not pumped efficiently through the heart to the rest of your body, blood and fluid can build up in your heart or lungs. Heart medicines can improve heart function and bring symptom relief. Other heart failure treatments may be necessary as well. Diabetes and Heart Disease Symptoms Excess blood glucose over an extended time can cause nerve damage to your blood vessel walls. Because of the damage, you may not feel the initial pain or discomfort related to angina (chest pain) or an actual heart attack. This may mean that problems with your heart are not detected as early as they might be for someone who does not have diabetes. Heart disease symptoms are the same for people who have diabetes and those who don’t. They include: Swelling in your lower legs, known as edema Feeling short of breath, even when not doing anything physically demanding Feeling faint or dizzy Chest pain or pressure, often extending to the left arm, shoulders, upper back, or jaw Nausea If you experience chest pain, especially if it’s accompanied by nausea and dizziness, call 911 immediately for urgent help. Tell the operator you think you are having a heart attack. Diabetic Heart Disease Contributing Factors Lifestyle plays a big role in managing type 1 and type 2 diabetes. Lifestyle can also play a role in preventing type 2 diabetes. Therefore, it’s important to keep as healthy a lifestyle as possible to reduce the risk of both type 2 diabetes and heart disease. Control blood glucose levels. One of the most important things you can do is measure your blood glucose, take your diabetes medicine, and go to your regularly scheduled doctor appointments and checkups. Maintain a healthy weight. If you are significantly overweight or obese, speak with your doctor about ways you can safely lose weight and maintain your blood glucose levels. Diabetes teams often have nutritionists who can help you learn how to eat a healthier diet. Exercise. It can be hard to get motivated to exercise, but a simple regimen of regular activity may decrease the medications you need to manage your diabetes, help you lose weight, and reduce the risk or severity of heart disease. The American Heart Association recommends at least 150 minutes a week of moderate-intensity exercise. If you like a more vigorous activity, this can come down to 75 minutes. You should also work on muscle strengthening activities at least twice a week. Don’t smoke. Smoking puts you at risk for heart disease even if you don’t have diabetes. Monitoring for Diabetic Heart Disease Since heart disease is a reality for many people with diabetes, it is important to be aware of your risk and the signs and symptoms of heart disease. People with diabetes are 2 to 4 times more likely to develop heart disease. To start, talk with your doctor about heart disease screening. Learn what tests you should do and how often. The most common screening tests for diabetic cardiovascular disease include: Blood pressure monitoring. Watching your blood pressure at regular intervals will indicate if it starts to climb, which could lead to hypertension (sustained high blood pressure). Blood tests. Blood tests to measure your cholesterol and triglycerides can be an indicator of your risk for developing plaques in your blood vessels. Electrocardiogram (ECG, or EKG). Electrodes placed on your arms, legs and chest measure the electrical activity from your heart. This tells your doctor how well your heart is pumping and if there are any irregularities. Echocardiogram. Using an ultrasound machine, sound waves from the wand are sent to the heart and then bounce back, making an image your doctor can see on a screen. Doctors order echocardiograms to look at heart structure and blood flow through your heart. Exercise stress test. This test shows your doctor how well your heart works when it is challenged. Your heart activity and blood pressure are monitored while you walk on a treadmill. If your doctor suspects you are developing heart disease, you may be referred to a cardiologist for further cardiac testing, such as a coronary angiogram. To perform a coronary angiogram, the doctor injects a dye into your bloodstream and follows it by X-rays as it moves with the blood. This allows the radiologist to see if there are any blockages or narrowed areas. Your test results will determine next steps, such as treatment. Diabetes is oftentimes a lifelong illness with some potentially serious complications. However, by following your treatment plan and taking good care of yourself, you can greatly reduce the risk of diabetes-related heart disease. Speak with your doctor about your risks and what you can do to help yourself.