Diabetes and Cardiovascular Disease

Cardiovascular disease is the primary cause of death in people with diabetes.

People with diabetes have two to four times the risk of developing cardiovascular disease. That is why people with diabetes are often prescribed medication to control their blood pressure and blood cholesterol.

Diabetes contributes to premature aging of the arteries and accelerates the process of atherosclerosis. Atherosclerosis is responsible for most cardiovascular events, such as stroke and myocardial infarction (heart attack).

Potential complications depend on the part of the body affected by atherosclerosis

  • Heart: angina, infarction (heart attack), heart failure, arrhythmia
  • Brain: stroke (presents with paralysis, aphasia, dizziness)
  • Lower body: pain when walking (limping), gangrene, amputation

Risk factors

In addition to diabetes, other factors can contribute to cardiovascular disease. They are calssiified as modifiable or non-modifiable.

Non-modifiable risk factors:

  • Age and gender: men over 45 and women over 55 or post-menopausal
  • Family history: immediate family members with a history of heart disease prior to age 55 or stroke before the age of 65
  • Ethnicity: First Nations, African or South Asian descent

Modifiable risk factors

  • High blood pressure
  • High blood cholesterol
  • Being overweight
  • Excessive alcohol consumption
  • Being sedentary
  • Smoking
  • Stress

Prevention

It is possible to influence modifiable risk factors. Adopting a healthy lifestyle helps protect cardiovascular health. The earlier we act, the sooner we increase the long-term benefits. Here are ways to achieve this:

Adopting healthy lifestyle habits can help reduce the risk of cardiovascular events. Some examples:

  • Adopt a heart-healthy diet
  • Do regular physical activity suited to your physical and medical condition
  • Healthy weight management
  • Consume alcohol with moderation
  • Optimal blood sugar control (fasting blood sugar between 4 and 7 mmol/L and 2 hours after meals between 5 and 10 mmol/L, A1C values equal to or less than 7%)
  • Optimal blood cholesterol control (C-LDL equal or below 2 mmol/L)
  • Optimal blood pressure control (values equal to or less than 130/80 mmHg)
  • Stop smoking
  • Take medication as prescribed
  • Medical monitoring: an annual blood test that analyzes your blood record and helps your doctor recommend appropriate treatment

Research and text: Julie St-Jean, R.D., Dietitian

January 2015

References:

Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, “Vascular Protection in People with Diabetes,” Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Treatment of Diabetes in Canada, (Canadian Journal of Diabetes, vol. 37, p. S582), Canadian Diabetes Association.

Unité de médecine de jour métabolique de l’Hôtel-Dieu du CHUM (2013), Connaître son diabète pour mieux vivre, Montréal: Les Éditions Rogers limitée.

Heart and Stroke Foundation, (2014) Risk factors you cannot control [Online]. Found at http://www.heartandstroke.qc.ca/site/c.pkI0L7MMJrE/b.3660139/k.F26E/Heart_Disease__Prevention_of_risk_factors.htm (Web page consulted January 29, 2015).