Diabetes and Heart Disease
Heart disease is a complication that may affect people with diabetes if their condition is not managed well for a prolonged period of time..
Coronary heart disease is recognized to be the cause of death for 80% of people with diabetes, however, the NHS states that heart attacks are largely preventable. 
How are heart disease and diabetes linked?
People suffering from type 1 and type 2 diabetes are more likely to be at risk from heart attacks, strokes and high blood pressure.
Vascular problems, such as poor circulation to the legs and feet, are also more likely to affect diabetes patients.
Like diabetes itself, the symptoms of cardiovascular disease may go undetected for years.
A Diabetes UK report from 2007 estimates that the risk of cardiovascular disease in people with diabetes is: 
- 5 times higher in middle aged men
- 8 times higher in women with diabetes.
More than half of type 2 diabetes patients will exhibit signs of cardiovascular disease complications at diagnosis.
Who does heart disease affect?
Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30.
Both type 1 and type 2 diabetics are at greater risk of developing heart disease.
What is the cause of heart disease amongst diabetics?
Hyperglycemia, which characterises diabetes, in combination with free fatty acids in the blood can change the makeup of blood vessels, and this can lead to cardiovascular disease.
The lining of the blood vessels may become thicker, and this in turn can impair blood flow.
Heart problems and the possibility of stroke can occur.
Diabetes and heart disease are closely linked. People diagnosed with type 2 diabetes, in particular, tend to have higher levels of cholesterol and blood pressure which contributes to heart disease risk.
As with most complications of diabetes, maintaining good blood glucose control is a key way to avoid the development of heart disease.
The following factors raise the risk of heart disease:
- Heart disease in a close relative
- Being overweight
- Being relatively inactive
- If you drink heavily or smoke
- Having high blood pressure
- Having high cholesterol
The risk of heart disease also gets larger with age. The symptoms of heart disease only appear once heart disease has been developing for some time. The symptoms may be noticed as chest pains, known as angina.
The pains which can be mistaken for indigestion can last for several minutes.
Some people may experience a heart attack as the first symptom which makes spotting the risks of heart disease before the symptoms occur even more important.
As someone with diabetes, you should have your blood pressure and cholesterol levels checked at least once a year. If you have a number of the risk factors, your doctor may advise you to have a diagnostic test for the presence of heart disease.
A number of different diagnostic tests exist and could include an electrocardiagram (ECG) test, x-rays or a coronary angiography.
Treatment for heart disease is based around lifestyle changes. Cutting down on smoking and alcohol and getting more exercise will help. You may also be advised to change your diet. These lifestyle changes are also recommended for people who wish to decrease their risks of heart disease later on in life.
People who have or are at risk of heart disease will commonly be prescribed cholesterol and blood pressure lowering drugs.
What symptoms can identify heart disease?
The following are common symptoms of heart disease, although this may vary from individual to individual:
- Pain in the chest
- Short of breath
- Irregular heartbeat
- Swelling of ankles
To assess your risk, it is necessary to take an EKG (electrocardiogram).
Angina (chest pain)
Angina is a symptom of coronary heart disease and can take two forms stable angina and unstable angina.
People with stable angina may notice pain or discomfort in the chest such as a tight, dull or heavy pain that passes within a few minutes. This pain may be brought on by angina triggers such as physical activity, stress or cold weather.
Let your doctor know if you notice the signs of stable angina.
A sign of unstable angina is if the symptoms persist for more than 5 minutes or if no angina triggers were present.
If you, or someone else, are experiencing the symptoms of unstable angina, dial 999 for ambulance services.
Heart attack (myocardial infarction)
A heart attack is commonly caused by a clot preventing blood supply to the heart.
The symptoms of a heart attack include a strong pain or tightness in the centre of the chest, shortage of breath, coughing and a strong feeling of anxiety.
If you, or someone else, appear to be having a heart attack call 999 for medical help.
Treatment for coronary heart disease
People with diabetes and signs of coronary heart disease will be advised to make lifestyle changes such as stopping smoking, eating a healthy, balanced diet and incorporating physical activity into each day.
Medication may also be prescribed. Common medications for treating heart disease include:
- ACE inhibitors
- Calcium channel blockers
- A low dose of aspirin
How can I prevent heart disease?
To prevent heart disease, a number of factors must be considered. It is imperative to control your weight, through regular exercise and a balanced diet, avoid or quit smoking (if you smoke), and limit the amount of alcohol that you drink. You should also have both your cholesterol and blood pressure checked at least once each year.
Consult a physician and base your prevention plan on their advice.
Controlling your blood sugar levels is also essential in both prevention and treatment, with research showing that reducing HbA1c by 1% decreases the risk of heart failure by 16% in people with type 2 diabetes.