Staying heart healthy with type 2 diabetes

picture of glucose monitor and stethoscope

Each year, more than one million people in the United States are diagnosed with diabetes. While type 1 diabetes often has a genetic component and is much more likely to occur in those who have a close relative with type 1 diabetes, type 2 diabetes is more common among people with certain risk factors. These include being overweight, not being active, high blood pressure and high cholesterol.

People with diabetes are at higher risk for heart issues, including heart attacks and congestive heart failure, so it’s critical to manage diabetes well.

Understanding diabetes

Type 1 diabetes is very different from type 2. Type 1 is an autoimmune disease usually diagnosed when patients are young, often around 4 to 6 years old. In rare cases, people are diagnosed when they are older with late-onset type 1 diabetes.

With type 1 diabetes, the immune system attacks the pancreas and then it can’t make insulin, which is a hormone that helps control how the body uses and stores sugar for energy. If autoimmune diseases (like thyroid disease, celiac disease and lupus) run in families, children have a higher risk for developing type 1 diabetes.

Type 2 diabetes is not a chronic autoimmune disease like type 1. The pancreas makes insulin, but the body can’t use it correctly. Type 2 diabetes is associated with the following risk factors that can come together to cause the disease:

  • Heart disease.
  • High blood pressure.
  • High cholesterol.
  • Weight (being overweight or obese).
  • Inactivity.
  • Smoking.
  • Polycystic ovary syndrome (in women).

While the ages and risk factors of patients with type 1 and type 2 diabetes are different, they have similar symptoms. They include:

  • Being very thirsty.
  • Feeling overly tired.
  • Losing or gaining weight without trying.
  • Having blurry vision.

People with these symptoms should contact their healthcare provider immediately.

Life with type 2 diabetes: protecting your heart

Diabetes can cause atherosclerosis, which is the narrowing or hardening of the arteries. People with type 2 diabetes can already have this condition, or develop it later. Both atherosclerosis and diabetes cause inflammation that can lead to heart disease.

People with type 2 diabetes can adjust their lifestyles to lower their risk of heart-related issues. The best ways to manage type 2 diabetes and risk factors—especially lowering blood pressure and improving cholesterol—are:

  • Exercising regularly: aerobic exercise for 30 minutes per day, 5 days per week.
  • Eating a diet high in fruits, vegetables, whole grains, nuts, seeds and oils—and low in sugar.
  • Avoiding smoking.
  • Taking medication specific to the patient (see below).

There are two types of drugs proven to protect the heart and reduce the risk of heart attack, congestive heart failure and death in people with type 2 diabetes. With various brand names and dosage options available, providers recommend the best option for each patient.

Current guidelines recommend that all type 2 diabetes patients take type 2 diabetes medication or cholesterol-lowering medication (usually a statin)—no matter their numbers, even if they’re in the normal range. This is to prevent inflammation that causes heart disease and other heart issues. The goal is to keep blood pressure in control: below 140/90 for adults.

By managing type 2 diabetes, patients can improve their heart health and enjoy better overall health.

To learn more about type 2 diabetes and heart health, visit the American Heart Association’s dedicated website 

Visit Dartmouth Health’s Diabetes Program

Stanislav Henkin, MD, MPH, Cardiovascular Medicine, Dartmouth Hitchcock Medical Center