The Connection Between Diabetes and Heart Health

If you have diabetes, chances are you’ve already been told how important it is to control your blood sugar levels to avoid potential complications of the disease. If you have type 2 diabetes, managing your condition means paying attention to more than just your glucose levels, though. Diabetes is among the strongest risk factors for heart and vascular disease. In fact, people with type 2 diabetes are 1.5 times more likely to have a stroke and two to four times more likely to die from heart disease compared to those who don’t have diabetes.

For the nearly 3 million North Texas residents who have diabetes, those odds can be frightening, but we spoke to Rebekah Mulligan, M.D., an internal and geriatrics medicine specialist and physician on the medical staff at Texas Health Southlake and Texas Health Adult Care, a Texas Health Physicians Group practice, for tips on how to manage both diabetes and heart health.

“When someone has diabetes, they have elevated blood sugar levels. This sugar enters your blood vessels throughout your body and can cause clogging of your arteries, which can eventually lead to a blockage,” Mulligan explains. “This blockage is what causes strokes, heart attacks and peripheral vascular disease. Diabetes gives you the same risk of having a heart attack as someone who has already had a heart attack.”

If you have diabetes, other controllable factors add to your chances of developing heart disease or having a stroke, such as smoking, high blood pressure, high cholesterol levels, being overweight and physical inactivity.



If you have diabetes, it’s important to stop smoking because both smoking and the disease contribute to the narrowing of blood vessels. Smoking also raises your bad cholesterol and blood pressure, which are risk factors in their own right.

Quitting can be hard, but thinking of your reasons for quitting, writing them down and looking at that list can help, as well as telling friends and family who can hold you accountable.


High blood pressure

Since diabetes contributes to narrowing blood vessels, the heart already has to work harder to pump blood throughout your body. Elevated blood pressure levels only compound the issue.

Eating whole -foods, watching sodium intake, limiting alcohol consumption and asking your health care provider about medications can help reduce your blood pressure.

Ideally, your blood pressure should be 120/80 or less, with readings over 130/80 considered high according to new blood pressure guidelines by the American Heart Association. Be sure to have your pressure checked during every visit to your doctor’s office, or consider purchasing a personal blood pressure monitor to use at home to record your levels daily.


High Cholesterol

Bad (LDL) cholesterol can lead to a buildup of plaque in the arteries. Generally speaking, the lower your LDL levels the better. Cholesterol is also affected by blood pressure and blood glucose, which increase your risk of heart disease.

Focus on eating nutritious foods that are low-fat, low-cholesterol and high in fiber, since fiber helps to lessen LDL cholesterol in the bloodstream. But be sure to read the label on low-fat packaged foods, since many companies increase sugar to counter the usual decrease it palatability that occurs when fat is removed.

Teaming up with a nutritionist to discuss healthy eating habits will not only help to achieve weight loss goals but also contribute to eating more diabetes-friendly meals and improving overall health.

Paige Vogl, a certified diabetes educator and registered dietitian at Texas Health Fort Worth, works with newly diagnosed patients and patients who have had diabetes for years, and she knows all too well how daunting the disease, and asking for help, can be.

“People always think dietitians are the food police!” she says with a laugh. “I think we really ease people’s fears when they come in because they’re very nervous about what’s going to be taken away from them, and they learn that it’s all a matter of controlling the carbohydrates and consuming a consistent level of those at each meal, so that it’s not necessarily that we’re omitting the carbs but we’re really just trying to focus on that consistent amount at each meal to help with blood sugar balance.”


Weight and physical activity

Being overweight not only raises your risk for heart disease and stroke, it can also increase your risk of high blood pressure, bad cholesterol and high blood sugar, which you already know by now increase your risk for a cardiac event.

Physical activity not only helps you lose weight but it can also lower your blood glucose, blood pressure, LDL cholesterol and triglycerides. It also improves your blood circulation and strengthens your heart.

“Make a goal of 150 minutes of aerobic exercise a week; this includes anything that gets your heart rate up and you are sweating,” Mulligan says. “For people who are just starting exercise, I recommend starting slow, around 15 minutes per day, and building to the 150 minutes a week. You can get this exercise in a variety of ways, including walking, gardening, kayaking, running, yoga, etc.”

A complete physical activity routine includes four kinds of activities:

  1.  Continuous activity — walking, using the stairs, moving around — throughout the day
  2.  Aerobic exercise, such as brisk walking, swimming or dancing
  3.  Strength training, like lifting light weights
  4. Flexibility exercises, such as stretching

In addition to working on the risk factors, both Mulligan and Vogl recommend seeking out a support group or online forum for diabetics to learn more about the disease and to foster connections with those who are going through the same things you may be going through.

“The group classes are nice because people can interact with each other and they can see that there are other people who have the same the disease, and they learn from each other,” Vogl says. “I think the personal connection that happens in those group classes can almost be more meaningful to the patient than anything else.”

Taking care of your diabetes is important to help you take care of your heart, starting with lessening your risk factors. The more risk factors you have, the higher your risk for having a cardiac event. Working with your physician or even a team of physicians who collaborate with one another to lessen your risk factors and prevent complications of diabetes can make managing diabetes and your heart health less challenging.

“Diabetes can be a very hard disease to treat and we can only be successful in treating it if we work as a team,” Mulligan explains. “I want to know if my patients have stopped medications due to side effects, cost, etc. I want to be there to support my patients if they have gained weight or are struggling to lose that extra weight. My role as a primary care physician is to support my patients in becoming as healthy as possible.”

For more information about prediabetes and diabetes or Texas Health diabetes outpatient centers, or to take a diabetes risk assessment, visit

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