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.
Research from 2017 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.
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.