Skip to main content
Submitted by Dr S. Patel on 25 November 2021

Persons with diabetes have a 2-to-3 fold higher rate of cardiovascular complications than those without diabetes. Read more about how diabetes increases the risk of complications and what can be done to manage this risk. Pro-tip: The best approach is to manage and control diabetes well. 

The diabetic population is known to have a 2-to-3 fold higher rate of complications than the non-diabetic population. While it is true that diabetes increases the risk of getting numerous complications, the risk can be significantly reduced by managing and controlling diabetes well.

Complications can not only be delayed but even prevented with timely control of the disease. Diabetes can affect several organs and systems in the body and can lead to serious health consequences. The damage to the heart and the vascular system is of utmost importance because it is the number one cause of death in diabetic patients.

The cardiovascular events caused by diabetes are primarily divided into three groups:

1.   Atherosclerosis

Atherosclerosis is the narrowing of the blood vessels in the body. This can be due to thickening of the vessel walls or fatty deposits along the lining of the vessels. As a result, less blood flow reaches the heart and its coronary arteries (arteries which supply the heart muscle) causing lack of oxygen to the heart muscle. This is called Coronary heart disease or Coronary Artery disease as part of the heart muscle stops functioning from no blood/oxygen supply.

Fatty plaque deposits due to high levels of bad cholesterol increases the formation of plaques or clots in the blood vessels. If a clot obstructs any of the coronary arteries, then it can cause heart attacks or myocardial infarcts. If the clot breaks off and reaches the brain, it can cause Stroke.

The stiffening of the blood vessels has a direct effect on increase of blood pressure thereby compounding the risk of cardiovascular events from sluggish blood flow. For more information on how Hypertension and Diabetes are connected, please read (link)

Signs and symptoms of Heart Attack to watch out for:

  • Chest pain or tightness
  • Pain on left arm, neck, jaw, or shoulder
  • Heartburn or discomfort
  • Difficulty breathing
  • Sweating
  • Tiredness
  • Dizziness
  • Nausea or vomiting

2.   Heart Failure

Heart Failure occurs when the heart overtime become too weak from low oxygen supply to be able to function properly. The pumping mechanism of the heart is decreased with low ejection fractions and the blood that travels to all the parts of the body is lessened. Heart Failure is a chronic and progressive complication of diabetes that can lead to heart enlargement, poor volume ejection and faster heart rate.

Signs/symptoms of Heart Failure that should be identified and reported:

  • Shortness of breath
  • Fast or irregular heartbeat
  • Nausea or vomiting
  • Coughing
  • Weakness
  • Fatigue
  • Swelling in the foot and ankles

3.   Cardiac Arrhythmias

Arrhythmias are irregular heartbeats. The rhythmic beating of the heart is controlled by electric firing. Changes in the heart structure or damage (such as a heart attack or heart failure) can cause disruptions in the rhythm causing the heart to beat faster, slower, or irregularly. Changes in blood glucose levels in diabetes along with obesity (including excess fat around the heart) are found to be the main contributors for cardiac arrythmias.

Arrythmias can be managed easily but if not detected on time can give rise to more chances of stroke and sudden cardiac death.

There are 5 types of Arrhythmias that can occur- Atrial Fibrillation, Ventricular Fibrillation, Supraventricular Tachycardia, Bradycardia and Heart Block.

Symptoms of Arrythmia that should be brought to your doctor’s attention:

  • Shortness of breath
  • Palpitations
  • Dizziness
  • Fainting

How to reduce your risk?

Keep a check on your ABCs and make the correct lifestyle alterations to reduce your risk of getting cardiovascular diseases.

A = HbA1c to be below 7%
B= Blood pressure maintain normal around 120/80
C=Cholesterol, LDL levels should be less than 70

Lifestyle changes

  • Stop smoking and use of all tobacco
  • Reduce alcohol intake
  • Cut down on salt, sugar and saturated fat intake
  • Exercise regularly ( moderate workout of 150 minutes per week or intense workout of 75 minutes per week)
  • Be more physically active and reduce sedentary time
  • Lose weight if you are obese or overweight
  • Manage your stress
  • Take your medications as prescribed

Persons with Diabetes should see their doctor regularly and monitor their blood glucose, cholesterol and blood pressure levels frequently so as to avoid any complications and reduce their risk of getting a cardiovascular event. If they notice any signs and symptoms of a heart problem, they must seek medical attention immediately.

Issued as part of the public education series by Boehringer Ingelheim India and PatientsEngage

 

References:

Grisanti L. A. (2018). Diabetes and Arrhythmias: Pathophysiology, Mechanisms and Therapeutic Outcomes. Frontiers in physiology, 9, 1669. https://doi.org/10.3389/fphys.2018.01669
American Diabetes Association. Oct 2021 https://www.diabetes.org/diabetes/complications/cardiovascular-disease
National Health System of the UK. Oct 2021 https://www.nhs.uk/conditions/arrhythmia/

Stories

  • Best Exercises for Diabetes Management
    Consulting Physiotherapist Nikita Morwal Kataria at Chellaram Hospital Diabetes Care and Multispeciality, Pune highlights the benefits of exercise for diabetes and helps you identify exercises good for diabetes management. In today’s chaotic world, it has been seen that increased sedentary behaviour greatly affects the health outcomes such as risk of obesity rates rising, lowered cardiorespiratory fitness and lowered insulin sensitivity in young people especially aged between 11-18 years old.…
  • Diabetes Terms Explained
    As you learn to navigate and manage diabetes, you will come across new terms. PatientsEngage has compiled an easy reckoner in alphabetical order to help you understand the terms associated with diabetes.  If you don't find the term you are looking for, please you leave a comment below or send us a note through contact us and we will update this content.       Beta cells Beta cells are found in the pancreas, as part of clusters called islets. They are…
  • Profile pic of Author Anjana with the cover of her book
    Stay Positive, Supportive And Calm When Parenting Child With Diabetes
    Anjana Tripathi was shocked to find her daughter diagnosed with type 1 diabetes at an early age of 14. Their world underwent a sea change trying to adjust to the needs of the condition. She shares here all the challenges that they as a family navigated. Anjana has even encapsulated her experiences in a rather well researched book. Please tell us about your daughter’s condition. When was she diagnosed? How old was she? My daughter deals on a daily basis with the chronic autoimmune disorder…
  • Eating Plan- Powerful Tool for Managing Diabetes
    Rima Rao, Registered Dietitian explains the basic tenets of a wholesome diet to manage diabetes, using the Diabetes Plate Method. She also addresses the topic of when and how much fruit a person with diabetes can consume.  "What should I eat?" is a typical question that people with diabetes ask. There is, however, no such thing as a “Diabetes Diet.” Some things that you can do include changing how you cook, how much you eat, when you eat it and what you cook with. When it comes to…
  • Travel Tips for Persons with Diabetes
    People with diabetes can travel safely and comfortably. They just need to follow a few travel guidelines. These tips have been curated based on inputs from experiences of frequent travelers with diabetes and vetted by Dr. Shital Patel. To begin with, it is important to note that diabetes related supplies are allowed on the plane.  Carry medications in hand luggage and in original packaging.  Insulin & insulin pens, alcohol swabs and unlimited numbers of unused syringes  …
  • An image with a hand crushing cigarette butts on the left and hands holding a heart to indicate how quitting tobacco saves the heart
    How Quitting Tobacco Improves Heart Health
    Tobacco increases risk of multiple heart diseases. But people who quit tobacco reduce their risk of dying from a heart disease significantly. Read more to understand the consequences of tobacco consumption and the benefits of quitting tobacco. Tobacco can affect the heart and the entire cardiovascular system including the blood vessels. According to the WHO and World Heart Federation, 1.9 million people die from tobacco-related heart diseases every year. Even occasional intake of tobacco and…
  • Patient Rekha on her diabetic retinopathy lived experience
    Never Neglect Eye Problems
    Rekha Khanduri, 73 from Mumbai has diabetes for a while and lost her eyesight due to diabetic retinopathy, a diabetes related complication. She talks about how she has since learnt to live with such an irreparable loss. Please tell us a bit about your condition : I have Blood Pressure as well as diabetes. In fact, I lost my left eye due to diabetes. When were you diagnosed with diabetes? About 35 years back. Diabetes runs in the family as both my grandfathers had it. My paternal grandfather had…
  • Thumbnail in green with text on blue strip: Can excess salt, sugar and junk food cause kidney disease in children
    Dangers Of Excess Salt, Sugar and Junk Food On Children's Health
    A panel discussion with Dr Rajan Ravichandran and Dr Arun Gupta highlighted the need for better product labeling and regulatory changes around advertising and marketing of processed foods. For parents to be aware of the link of salt, sugar and ultra processed foods with diabetes, hypertension and Chronic Kidney Disease in children. (Video below) Participants: Dr Rajan Ravichandran – Senior Nephrologist (RR) Dr Arun Gupta – Pediatrician (AG) Aparna Mittal, Founder , PatientsEngage (AM)  …
  • Managing Diabetes And A Hamstring Injury
    Dr. R.Asha Rajini, 66 from Chennai loves running marathons. A hamstring injury upset her rhythm and affected her physical and mental health, especially  diabetic control. She talks about the challenges of dealing with this setback and the lessons she learnt in the process of recovery  I was doing very well in my running training, almost every Sunday I was running about 21 to 25kms as I was getting ready to run a 50km Ultra in November 21. On August 13th I went to the gym to strengthen…
  • A man sleeping with a CPAP machine attached to his face
    मैंने अपनी स्लीप एपनिया समस्या को कैसे ठीक किया
    दिल्ली के 42 वर्षीय रोहन कपूर पिछले पंद्रह वर्षों  से ऑब्सट्रक्टिव स्लीप एपनिया विकार से जूझ रहे हैं, और बिना किसी बाधा के नींद लेने के लिए मशीन का उपयोग करते हैं। कृपया हमें अपनी स्थिति के बारे में कुछ बताएं मुझे 2004 से ऑब्सट्रक्टिव स्लीप एपनिया (ओएसए, अश्वसन) है, और मेरा निदान स्लीप टेस्ट के माध्यम से किया गया था। मैं नींद के लिए एक सीपीएपी (CPAP) मशीन का उपयोग करता हूं और इस उपकरण की वजह से मेरी स्थिति का सफलतापूर्वक प्रबंधन हो पा रहा है। Read in English: How I fixed my sleep…