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Diabetes and Cardiovascular (Heart) Disease

What is diabetes?


Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, which usually occurs during childhood or adolescence; and type 2, the most common form of the disease, usually occurring after age 45, but is increasingly being diagnosed in children and adolescents.

Diabetes is the fifth-deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States.

What is the link between diabetes and CVD?


The most life-threatening consequences of diabetes are heart disease and stroke, which strike people with diabetes more than twice as often as they do others. Most of the cardiovascular complications related to diabetes have to do with the way the heart pumps blood through the body. Diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely. This is called atherosclerosis, or hardening of the arteries, and diabetes seems to speed it up.

Unfortunately, the risk of cardiovascular disease among people with diabetes is dramatic: a diagnosis of diabetes as an adult presents the same risk as already having one heart attack. More than 65 percent of deaths in diabetes patients are attributed to heart and vascular disease.

What is the impact of diabetes and CVD?


  • Heart disease strikes people with diabetes, twice as often as people without diabetes.

  • In people with diabetes, cardiovascular complications occur at an earlier age and often result in premature death.

  • People with diabetes are two to four times more likely to suffer strokes and once having had a stroke, are two to four times as likely to have a recurrence.

  • Deaths from heart disease in women with diabetes have increased 23 percent over the past 30 years compared to a 27 percent decrease in women without diabetes.

  • Deaths from heart disease in men with diabetes have decreased by only 13 percent compared to a 36 percent decrease in men without diabetes.

What are some of the other diabetes-related complications in addition to CVD?


  • Blindness. Diabetes is the leading cause of new cases of blindness in people ages 20-74. Each year, from 12,000 to 24,000 people lose their sight because of diabetes.

  • Kidney Disease. Diabetes is the leading cause of end-stage renal disease, accounting for about 43 percent of new cases. In 2000, approximately 41,046 people with diabetes initiated treatment for end stage renal disease (kidney failure), and 129,183 underwent dialysis or kidney transplantation.

  • Nerve Disease and Amputations. More than 60 percent of nontraumatic lower-limb amputations in the U.S. occur among people with diabetes. In fact, diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15-40 times greater for a person with diabetes. Each year, more than 82,000 amputations are performed among people with diabetes.

What is needed to "break the link" between diabetes and CVD?


People with diabetes can take some steps to lower their risk of heart disease and stroke. Learn the diabetes "ABCs."

  • A = A1C, or hemoglobin A1c test, which measures average blood glucose over the past 3 months
  • B = Blood pressure
  • C = Cholesterol

Target ranges are as follows:

  • A  A1C < 7 percent   Check at least twice a year.
  • B  Blood Pressure < 130/80 mmHg   Check at every doctor's visit. 
  • C  Cholesterol-LDL < 100 mg/dl   Check at least once a year.

Patient education is critical. People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose, blood pressure and cholesterol levels, and receive regular checkups from their health care team.

Lifestyle changes are extremely valuable. Smokers should stop smoking and overweight men and women with diabetes should develop a moderate exercise regimen under the guidance of a health care provider to help them achieve a healthy weight.

Health care team education is vital. Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease. A team approach to treating and monitoring this disease serves the best interests of the patient.