reduce risk of heart attack and stroke
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Expert-reviewed by Ashwini S.Kanade, Registered Dietician and Certified Diabetes Educator with 17 years of experience

Diabetes isn’t just about high blood sugar levels. It is a condition which can affect many of your vital organs, including your heart and brain.

Are you at risk of heart disease and stroke?

  • Up to two-thirds of people with diabetes have high blood pressure (hypertension) which is considered a powerful risk factor for heart disease.(1) So if you have high BP with diabetes, then your risk is further increased.(2)
  • Unhealthy cholesterol levels, obesity, physical inactivity, etc.  
  • Smoking has been shown to significantly increase the risk of cardiovascular disease.(3)
  • Women with diabetes are three times more likely to have heart disease or stroke compared to women without diabetes even if they don’t smoke, have maintained their weight and physical activity levels. (4) Here’s everything a woman with diabetes should know.
  • Surprisingly, dangerously low sugar levels (hypoglycaemia) can be a risk factor too.(2)

Watch out for the warning signs

Various CVDs come with their own set of symptoms – from no symptoms to palpitations to chest pain. Some symptoms are obvious and some are not. A weak heart can greatly affect your quality of life. It can leave you fatigued, breathless, non-energetic, and sleepless. A poorly fed brain makes you disoriented and light-headed. Read these expert tips on how to fight tiredness caused by diabetes.

A heart attack may cause pain or discomfort in your chest. Or you may feel the pain or discomfort in your left shoulder, jaw or back. You may also experience nausea, vomiting and breathlessness.

A stroke may leave you numb on the face, hands or leg, most often on one side of your body. You may be confused and find it difficult to speak. There may be a loss of balance or coordination and you may lose consciousness.

Here are some early signs of diabetes-related complications that you might be missing out.

How does diabetes really affect the blood vessels and the heart?

If the pipelines supplying water to your house were clogged, your water supply would decrease, right? In the same way, high sugar levels damage the vessels supplying blood to the heart, brain and clog them.

Blockage of blood vessels supplying your heart causes a heart attack. And people with diabetes are at a twofold excess risk for it. Additionally, the heart attack related to diabetes is about a third more fatal.(5) And it isn’t just heart attacks. The damage that diabetes does to the blood vessel in the brain substantially increases your risk of stroke.(6)

You can reduce the risk

How well you manage your diabetes can determine whether or not you are likely to develop cardiovascular disease. Also, you can avoid or delay their development by identifying and managing the risk factors like excess body weight, physical inactivity, smoking, high blood pressure and high cholesterol.

Maintain your blood sugar within the target levels. Exercise regularly. Eat a healthy diet. Maintain low cholesterol levels. Kick the butt. The negative consequences of smoking cannot be stressed enough, especially in people with diabetes. Don’t miss your appointments with your doctor. Get an annual testing done to assess your cardiovascular risk factors.

According to ADA recommendations:(7)

  • Aim for weight loss if overweight or obese.
  • Reduce sodium and increase potassium intake in your diet.
  • Increase your physical activity.
  • Moderate your alcohol intake.
  • Blood pressure should be checked at every routine visit.
  • If you have hypertension with diabetes, the blood pressure target should be 140/90 mmHg.
  • If you are at high risk of CVD, a goal of 130/80 mmHg may be set if it can be safely achieved.
  • If you are a pregnant woman with diabetes and high BP, the targets of 120–160/80–105 mmHg are suggested.


  2. Fox CS, Golden SH, Anderson C, Bray GA, Burke LE, de Boer IH, Deedwania P, Eckel RH, Ershow AG, Fradkin J, Inzucchi SE, Kosiborod M, Nelson RG, Patel MJ, Pignone M, Quinn L, Schauer PR, Selvin E, Vafiadis DK; American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health, Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, Council on Quality of Care and  Outcomes Research, and the American Diabetes Association. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Circulation. 2015 Aug 25;132(8):691-718. doi: 10.1161/CIR.0000000000000230. Epub 2015 Aug 5. Review. PubMed PMID: 26246173.
  3. Pan A, Wang Y, Talaei M, Hu FB. Relation of Smoking with Total Mortality and Cardiovascular Events Among Patients with Diabetes: A Meta-Analysis and Systematic Review. Circulation. 2015;132(19):1795-1804. doi:10.1161/CIRCULATIONAHA.115.017926.
  4. Spencer EA, Pirie KL, Stevens RJ, Beral V, Brown A, Liu B, Green J, Reeves GK; Million Women Study Collaborators. Diabetes and modifiable risk factors for cardiovascular disease: the prospective Million Women Study. Eur J Epidemiol. 2008;23(12):793-9. doi: 10.1007/s10654-008-9298-3. Epub 2008 Nov 18. PubMed PMID: 19015938.
  5. The Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215-2222. doi:10.1016/S0140-6736(10)60484-9..
  6. Janghorbani M, Hu FB, Willett WC, Li TY, Manson JE, Logroscino G, Rexrode KM. Prospective study of type 1 and type 2 diabetes and risk of stroke subtypes: the  Nurses’ Health Study. Diabetes Care. 2007 Jul;30(7):1730-5. Epub 2007 Mar 27. PubMed PMID: 17389335.
  7. American Diabetes Association. Cardiovascular disease and risk management. Sec. 9. In Standards of Medical Care in Diabetesd2017. Diabetes Care 2017;40(Suppl. 1): S75–S87

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