Cardiovascular Disease and Diabetes

Cardiovascular Disease and Diabetes - One Drop

It’s National Heart Month!

Did you know that cardiovascular disease is the leading cause of death worldwide for adults with diabetes? ⁣💔

That’s right: heart attacks and strokes. Not DKA, not hypoglycemia. It’s cardiovascular disease. ⁣

Heart attacks and strokes happen earlier and more often (increased risk is highest with more than 10 years living with diabetes and people older than age 28) in people with type 1 diabetes than their non-T1D counterparts.

In general, people with type 1 diabetes are 3 to 10 times more likely than the general population to have a heart attack. Similarly, people with type 2 diabetes are 2 to 4 times more likely than others to develop cardiovascular disease.

What’s Causing This?

Hyperglycemia creates a complex series of events that leads to blood vessel damage and, ultimately, heart disease. But where does it begin?

High blood sugars lead to inflammation in our blood vessels and organs. That inflammation promotes the formation of atherosclerotic plaques, which increase risk for heart attacks and strokes.

It’s even more increased in people with diabetes who also have chronic kidney disease. The combination can cause dyslipidemia, inflammation, and increased risk of a cardiovascular event. ⁣

What’s more, diabetes (all types) is what’s called a “CVD equivalent,” meaning that people with diabetes are at just as much risk for having a heart attack as someone who has already had one. This is because insulin resistance and metabolic syndrome also lead to inflammation in our blood vessels, dyslipidemia, hypertension, and increased risk for cardiovascular disease. ⁣

But what if blood sugars are relatively stabilized? What if there’s no major hyperglycemia risk? If the major mechanism for increased cardiovascular risk in people with diabetes is hyperglycemia and not underlying insulin resistance, then if my blood sugars are good then I’m good, right? ⁣

Yes. And no.

Studies do show decreased cardiovascular disease risk with decreased A1C (risk is lowest at <6.5-7%) in people with type 1 diabetes, whereas lower A1C is not protective in people with type 2 diabetes.

But, as rates of obesity, metabolic syndrome, and insulin resistance rise in all across the board, simply lowering A1C won’t help and cardiovascular disease risk stays at an increased rate regardless of A1C. ⁣

How to Reduce Cardiovascular Disease Risk

So can we reduce our risk? Is it worth it to try?

Yes! All of us can lower our risk of heart disease. And we can do it without taking any pills. Natural ways to lower heart disease risk include:

Start showing your heart some love today! Make quick, easy adjustments to things like lifestyle and nutrition to keep your heart healthy, and you happy.

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Jordan Hoese, MD, MPH
Feb 20, 2020

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