Diabetes and the Deadly Link to Heart Disease

Li Zhang, MD – Cleveland Clinic Florida Cardiologist

February 1, 2017

While the strong connection between diabetes and heart disease is well-known, the statistics may be much higher than you think. Diabetics are twice as likely to develop heart disease or have a stroke, and according to the National Institutes of Health (NIH), the comorbidity rate of heart disease or stroke for diabetics is approximately 65%.

Link between Diabetes and Heart Disease

As a major complication of diabetes, heart disease is the leading cause of early death among diabetics. “There are a number of contributing factors for this. First and foremost, high blood glucose levels elevate the risk of heart attack, stroke and coronary artery disease, by contributing to the formation of fatty deposits in the blood vessel walls,” according to Li Zhang, MD, Cleveland Clinic Florida cardiologist.

This damages the arteries and obstructs blood flow, causing blood vessels to harden over time. “Additionally, diabetics typically have secondary issues, such as high blood pressure and obesity, which contribute to the development of heart disease,” says Dr. Zhang.

Warning Signs

When blood vessels become narrowed you may feel chest pain or discomfort, also referred to as angina.  This results from a reduced blood supply to the heart. Although angina does not cause permanent heart damage, it does increase risk of a heart attack, which occurs when the blood supply to the heart becomes blocked. Heart attack results in permanent damage, so prompt medical attention is critical in improving odds of survival.  It’s important to recognize the warning signs:

  • chest pain or discomfort
  • pain or discomfort in your arms, back, jaw, neck, or stomach
  • shortness of breath
  • sweating
  • nausea
  • light-headedness

However, diabetes can also cause nerve damage resulting in a lack of pain, which could mask these symptoms.  As a result, your risks for heart disease should be closely monitored, and if you are at high risk or do have symptoms, you should undergo appropriate screenings.

How to Lower Your Risks

There are lifestyle changes you can make to control risk factors associated with diabetes and heart disease. The statistics may not be in your favor, but here are some things you can do:

  • don’t smoke, as it doubles the risk of heart disease for diabetics
  • maintain a healthy diet in order to manage weight and control sugar levels
  • keep your blood pressure in the healthy range
  • control your cholesterol level
  • exercise 30 minutes per day, five days a week

Take Action

Talk to your doctor and healthcare team to develop an action plan.  “Set goals to maintain and take control of these risk factors, in order to reduce your chances of developing heart disease if you are diabetic,” states Dr. Zhang.

Your lifestyle plays a big part in controlling your health. You can make the appropriate changes by increasing your daily activity, as well as eating foods low in saturated and trans-fats, cholesterol, salt, and added sugars.  Make sure that you are eating a nutritious, well-balanced diet by choosing lean meats, fish, poultry, fruit, vegetables, whole grains, low-fat dairy, and be sure to include enough fiber.

“If you smoke, then quit, and don’t be afraid to ask for help.  Your healthcare provider can assist you in the process of smoking cessation,” says Dr. Zhang.

Take your medications as directed, and make sure to check your sugar levels at the proper intervals.  You can also enlist the help of family and friends in managing your diabetes, as their support can help you reach your goals.


For a consultation with a Cleveland Clinic Florida specialist call 866.293.0621,

or visit clevelandclinicflorida.org/heart.