The crucial link between diabetes and heart disease

Blame glucose levels. High blood glucose damages nerves and blood vessels, making people with diabetes more vulnerable to the long-established risk factors for cardiovascular disease:

smoking, high blood pressure, abnormal cholesterol levels and triglycerides. More than 90 percent of people with diabetes have at least one of these additional risk factors. FOR EXPERT TIPS

TO HELP FEEL YOUR BEST, GET AARP’S MONTHLY _HEALTH_ NEWSLETTER. “What people need to know is that all these conditions — high blood pressure, high cholesterol and high blood sugar — are

really one and the same,” says Joel Zonszein, director of the Clinical Diabetes Center at the University Hospital of Albert Einstein College of Medicine in New York City, and principal

investigator of an ongoing National Institutes of Health-sponsored study to find the best way to manage coronary artery disease in people with diabetes. “So when we treat type 2 diabetes, we

don’t just treat the blood sugar. We want to make sure the blood pressure, cholesterol and blood sugar are all normal. And we want to do that very early in the disease.” That includes

prediabetes, too. More than 1 in 3 adults in the U.S. have prediabetes, which means their blood glucose is higher than it should be but not high enough to meet the threshold for diabetes.

Although they aren’t as vulnerable to heart disease as someone with full-blown diabetes is, they are still at risk. “Many large, long-term follow-up surveys have shown that those with

prediabetes have about a 50 percent increased incidence for cardiovascular outcomes, compared with about 200 percent increased incidence in those with diabetes,” Ganda says. “People with

prediabetes often have elevated lipids — high cholesterol, high triglycerides, low HDL [good] cholesterol, obesity and high blood pressure — for many years before diabetes may be diagnosed.

This is the ideal time to start paying attention to health by improving lifestyle.” LOWER YOUR RISK Whether you have prediabetes or full-blown diabetes, you can’t do anything about some of

the major risk factors for cardiovascular disease, such as age (as you get older, your risk of heart disease and heart attack rises) and genetics (if you have a family history of early heart

disease, your own risk increases). But there’s plenty you can do to combat the other factors that raise your risk for diabetic heart disease. For instance:  1. MAINTAIN A HEALTHY WEIGHT. 

Being overweight tends to increase your blood glucose, blood pressure and blood fat levels. Even a modest 10- to 20-pound weight loss can improve your levels. 2. EXERCISE. Not only is

regular physical activity associated with better blood glucose levels, it can also help reduce blood pressure. Aim for at least 30 minutes of moderate-intensity aerobic exercise (a brisk

walk, for instance) most days of the week, and at least two strength training sessions per week. 3. MANAGE STRESS. Stress and anxiety cause arteries to tighten, raising your blood pressure

and your risk of having a heart attack. 4. DON’T SMOKE. If you have diabetes, you’re already at risk for heart and blood vessel problems. Nicotine only exacerbates the problem by damaging

and tightening blood vessels, raising blood pressure and blood glucose, and leading to unhealthy cholesterol levels.