Cardiovascular disease – why living with type 2 diabetes doesn’t have to
Being diagnosed with type 2 diabetes means that you have an increased
risk of developing cardiovascular disease. Therefore, it’s a good idea
to know the facts, take them seriously and take steps to reduce your
cardiovascular risk as much as possible. In other words, it’s a
good idea to continue reading because we will cover all that here.
If you are a regular reader of the articles on this website, you will
be very familiar with the symptoms of type
2 diabetes. You will also know that the principal type 2
diabetes symptom – high blood sugar levels, or hyperglycaemia – can be
managed through a combination of medication, physical activity and a
carefully laid meal plan.
That knowledge will come in handy as we explore the relationship
between type 2 diabetes and cardiovascular disease. Why? Because it
turns out that high blood sugar levels are strongly correlated with
Time for a heart-to-heart
Let’s start with a quick note on terminology: Cardio means related to
the heart. Vascular means related to the blood vessels.
Thus, cardiovascular disease is simply the name given to a class of
diseases affecting the heart and blood vessels.
High blood sugar levels can damage the walls of blood vessels.
Therefore, the longer a person lives with diabetes, the higher the
risk of developing cardiovascular disease.1,2
Furthermore, studies show that high blood sugar can damage the nerves
that control the heart and blood vessels.3
When there is damage to the blood vessels, fatty material (sometimes
referred to as “plaque”) can build up and obstruct the blood flow.4
At least two problems directly spring from this:
First, the body’s organs require a steady supply of
oxygen-rich blood to keep functioning normally. They cannot maintain
healthy functioning for long in the absence of healthy circulation,
a condition known as ischemia.5
Second, when the
build-up of fatty material limits the body’s ability to send blood
to the organs, the body typically responds by pumping the blood
harder. In medical terms, this is known as increased blood
The problem is that the heart and vessels are not able to circulate
blood well under these conditions in the long run. Over time, the risk
of actual damage to the heart goes up and may take the form of
irregular heartbeat, heart attack or stroke.6
A sticky situation
There is a further complication to living with high levels of blood
sugar. It can result in the blood sticking together and forming blood
clots.7 A blood clot that travels to the arteries or veins
in the brain, heart, kidneys, lungs or limbs can cause serious
problems: heart attack, stroke, organ damage or even death.8
It is for these reasons that we want to encourage you – especially
if you are living with type 2 diabetes – to take the relationship
between high blood sugar levels and increased cardiovascular risk seriously.
Where to start – and how?
When it comes to cardiovascular disease, preventive efforts are
primarily to do with lifestyle management and risk factor
interventions. However, in a great many cases, optimal treatment also
has a medical dimension. Certain blood sugar lowering treatments can,
for example, help lower your risk for heart attack or stroke.9
Remember that every condition is different and requires a personal
approach. Why not have a conversation with your doctor about it this
week and see what would work best in your case?
It is important to be aware that despite achieving good blood sugar
levels, you are still at higher risk of a heart attack or
stroke.10 However, the good news is that with healthy
lifestyle choices you can lower the risk of heart attack and stroke,
especially in combination with medication.11 And here it is
important to discuss with your doctor if your blood glucose lowering
medication can help reduce your cardiovascular risk.
There are many ways to define a healthy lifestyle, so let’s get
precise. In this context, making “healthy lifestyle choices” refers to
the constant attempt to limit exposure or vulnerability to known
causes of narrowing or clogging in blood vessels.
In addition to high blood pressure and high blood sugar levels, as
pointed out above, these include:
Living with high cholesterol Clinical evidence shows that a cholesterol level reduction
may lower the mortality rate from cardiovascular disease. However,
bear in mind that cholesterol is not one thing. It’s important to
distinguish triglycerides from "good" and “bad"
cholesterol (HDL and LDL, respectively).12 Talk to your
doctor about keeping your blood triglyceride level under 2 mmol/L
and your HDL equal to or greater than 1mmol/L. Your LDL cholesterol
levels should be <2mmol/L and Total cholesterol <4mmol/L.
Eating unhealthy food A nutritionally limited or poor diet can lead to high
cholesterol and high blood pressure.12 Eating high
amounts of sodium/salt can also lead to high blood pressure by
preventing fluids from leaving the body.14
Smoking Smoking is also a significant risk factor for CVD. The
harmful substances in tobacco can damage and narrow your blood
Drinking too much alcohol Studies have indicated a positive correlation between
cardiovascular mortality and alcohol when consumed above recommended
Physical inactivity Regular exercise can help reduce body fat and thus increase
sensitivity to insulin in the cells.16 As a result, blood
sugar can better enter the cells and is less likely to build up in
Living with obesity As mentioned above, there is a correlation between the
reduction of body fat and insulin sensitivity. Receiving help or
finding ways to address excess weight is therefore a great way to
achieve steady blood sugar levels. Physical activity is merely one
of several ways.
Fortunately, evidence suggests that even modest, and therefore
achievable, alterations of the risk factors associated with lifestyle
can have substantial effects on a person’s cardiovascular risk.17
What does this mean for you who are living with type 2 diabetes?
Like any other chronic disease, type 2 diabetes is a lifelong
disease. Achieving a life full of meaning, achievement and happiness
despite the associated cardiovascular risks will depend on:
developing a healthy lifestyle
careful monitoring of blood sugar levels
a guide to help you have a good conversation with your healthcare
provider about the current state of your type 2 diabetes with regards
to cardiovascular risks.
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