Coronary heart disease (also called cardiovascular disease, or just heart disease) is a very common complication of diabetes that can occur if blood sugar levels are not managed well.

About 40% of all American deaths are attributed to heart disease, making it the number 1 killer in the USA.

What is heart disease?

Heart disease is what happens if the blood supply to your heart gets restricted. This can commonly occur as a consequence of fatty substances building up in the arteries.

The heart is a muscle, and like all muscles, it needs a constant supply of blood. Coronary arteries are the small blood vessels that deliver oxygen-rich blood and glucose to the heart muscle, and take away the waste products the heart generates.

Fatty deposits can build up in these arteries, along with any other artery in your body. This is a process known as atherosclerosis, and can be caused by a variety of factors.

These factors include

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes

In addition to causing high blood pressure, atherosclerosis can cause clots to form in the vessels, which could then break off and travel around the body, possibly causing blockages elsewhere. This can lead to strokes or heart attacks.

How does diabetes cause heart disease?

Atherosclerosis, the buildup of fatty deposits on the walls of the arteries, is usually caused by a sedate lifestyle and an unhealthy diet. Having high blood glucose and triglyceride levels can increase the risk of developing restricted blood vessels.

Because type 2 diabetes is commonly, though not always, brought on by living an unhealthy lifestyle, people diagnosed with type 2 diabetes are at increased risk of developing heart disease either before or after being diagnosed with diabetes.

High levels of glucose in the blood, which occur if diabetes is not managed effectively, can also damage the walls of arteries. As a result of this, people with diabetes are generally more susceptible to heart disease.

What are the symptoms of heart disease?

The symptoms of heart disease come from having partially or fully blocked coronary arteries. As such, the symptoms are mostly to do with the heart and the chest. People with the disease may experience any combination of the symptoms, or none at all until the disease is diagnosed.

In early heart disease, heart palpitations (strong or abnormal beating) and arrhythmia (heart beats that don’t follow the normal rhythm) can occur. On their own, palpitations do not necessarily indicate heart disease, and may be related to other issues such as panic attacks, or be caused by things such as medication.

Angina is another sign of coronary heart disease. This is the general term used to describe a pain in the chest that can range from mildly uncomfortable to a strong, painful feeling of tightness, even spreading into the back, neck and arms. It is usually triggered by some form of physical activity and will pass in around ten minutes, or can be relieved with some medications.

One of the major complications of heart disease is a heart attack (myocardial infarction), and this could well be the first symptom people with heart disease exhibit.

Heart attacks are very serious and can feel like an extreme form of angina, especially with a tight feeling across the chest and down the arms. A heart attack is caused by the blood flow that feeds the muscle of the heart being blocked off to the point where the heart can stop working effectively.

Other less severe symptoms of heart disease include:

  • Coughing
  • Dizziness
  • Fatigue
  • Nausea
  • Shortness of Breath
  • Sweating
  • Swelling
  • Anxiety
  • Discomfort in the chest

Note that this is not a comprehensive list of all possible symptoms, but are the main ones you are most likely to notice.

If you exhibit any of the above symptoms (both major and minor), book an appointment with a doctor as soon as possible. In the event of angina or a heart attack, immediate medical assistance is a must.

Complications of Heart Disease

Heart Attacks and Strokes

The two most dangerous complications of heart disease are heart attacks and strokes. Heart attacks are a lack of blood flow feeding the heart muscle. Strokes are often caused by a lack of blood flow to the brain, which can be caused by blood clots. Strokes can also occur as a result of hemorrhage, a burst blood vessel in the brain.

The blocked blood flow to the heart or brain is often the result of a blood clot which can form as a result of having a high level of fat deposits on the walls of the arteries. If a blood clot affects an artery feeding the heart or brain, this can result in a heart attack or stroke.

Another possible cause is if a plaque of fatty deposits, which has developed elsewhere in the body, breaks up and the debris gets carried through the blood and gets lodged in one of the arteries feeding the heart or brain.

It is important to seek medical aid as soon as possible if you or someone you know if experiencing a heart attack or a stroke.

Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) is a reduction in blood flow to the extremities, particularly the legs, caused by a fatty build up in the arteries.

The signs of PAD are a pain in the legs, particularly when walking or exercising, and also cramp, although the Centers for Disease Control (CDC) states that 40% of sufferers experience no leg pain.

PAD can cause a lot of problems, especially when coupled with diabetic neuropathy which can also greatly affect the health of the feet.

It can lead to muscle atrophy, hair loss, cold skin (especially when accompanied by leg pains), decreased or absent pulses in the feet and non-healing ulcers on the legs and feet.

Heart Failure

Heart failure should not be confused with a fatal heart attack, although it does have similarities.

Heart failure is quite simply the heart failing to continue beating, due to a number of possible reasons. A heart attack on the other hand is tissue damage on the heart as a result of blocked coronary arteries.

Complications of heart disease such as high blood pressure (hypertension) and a reduced blood flow to the heart are among the major causes of heart failure, and both of these can be brought on by uncontrolled diabetes.

By maintaining a healthy weight and eating a balanced diet, as well as reducing all the risk factors of heart disease, you can lower your chances of developing heart failure.

Can you prevent heart disease?

Heart disease can be prevented, but there is no quick and easy answer to it. It’s all about altering your lifestyle and making it healthier by combating the risk factors that can lead to heart disease.

Diabetes Management

As the high levels of blood glucose, commonly experienced by diabetics, can damage the arteries and cause heart disease, keeping a tight control of diabetes will reduce the risks of developing cardiovascular complications.

In fact, research has shown that reducing A1c by just 1% slashes the risk of heart failure by 16% in people with type 2 diabetes.


The food you eat has a huge effect on cardiovascular health, so keeping to a healthy, balanced diet with plenty of fruit and vegetables and keeping to a healthy calorie intake will reduce the risk of heart problems and stroke.


Exercising will keep your body working well and help regulate blood glucose, cholesterol, triglyceride and blood pressure levels.

According to the CDC, an adult should be aiming to do at least 150 minutes of moderate intensity physical activity a week (such as brisk walking). But the general rule is that the more, the better.

Muscle strengthening activities should be undertaken on two or more days of the week, to get all major muscle groups working. You should aim to exercise the legs, hips, abdomen, back, shoulders, chest and arms.

If time is something of an issue, the CDC say that 75 minutes of vigorous-intensity activity will substitute. This would include activities like sprinting or jogging. Even when substituting moderate exercise for intense exercise, you still should carry out muscle exercises on at least two days of the week.

Quitting Smoking

Smoking is a huge contributor to the development of heart disease. The chemicals inhaled when smoking can damage the walls of the arteries in a similar way that high levels of blood glucose can, making fatty deposits more likely to build up and raise blood pressure, contributing to heart disease.

How is heart disease treated?

The main treatment for early stage heart disease is an alteration to lifestyle. Quitting smoking, eating a healthy and balanced diet, and getting more physical activity every day can go a long way to reducing the risk of serious health complications.

In addition to a healthier lifestyle, there are some types of medication that can be used to treat heart disease. These include:

  • ACE inhibitors
  • Statins
  • Calcium channel blockers
  • And aspirin

In some cases, more drastic treatments and therapies are used, particularly if the patient has already suffered a heart attack. These include:

  • Angioplasty and stents –  small mesh tubes used to prop open the coronary arteries
  • Heart bypass surgery – surgical procedure to give the blood an alternative route to the heart