Because diabetes and heart disease are linked, treatment plans for diabetes shouldn’t focus only on controlling blood sugar levels. Treatment must address other cardiovascular risk factors, too. This approach might include:

• Ongoing assessment of cardiovascular health (for example, watching cholesterol panels, blood pressure or protein in the urine)
• Steps to help protect your heart health with lifestyle changes (for example regular exercise, heart-healthy diet, good sleep habits) and possibly medications to help control high blood pressure or cholesterol
• Referrals to other providers to support a coordinated, team-based approach to your care
• Routine vaccination against the flu and pneumonia to prevent illnesses that can stress the heart

Do You Have Heart Disease?

If you have heart disease but haven’t been screened for type 2 diabetes, ask to be tested. Many people with heart disease also have diabetes, but they often remain undiagnosed.

The sooner you know, the sooner you can take steps to lower your risk. Many people have prediabetes, an early warning sign for diabetes. At this stage, they can make changes to help prevent the onset of the disease.

ABCs of Diabetes

The “ABCs of diabetes” is widely used as a reminder of the importance of tracking your blood sugar numbers, along with your blood pressure and cholesterol. High blood pressure and high cholesterol are well-known risk factors for heart disease and stroke.

In addition to knowing your numbers, lifestyle changes are recommended to manage diabetes, and sometimes medications are as well. So if you’re living with diabetes, try to remember these ABCDEs:

A is for A1C, or HbA1c, which is a test that measures blood glucose control over the past two to three months. The A1C target for most people is under 7%.

B is for blood pressure. Nearly 2 out of 3 people with diabetes have high blood pressure. For most people with high blood pressure and diabetes, blood pressure levels should be <130/80 mm Hg.

C is for cholesterol. Total cholesterol, LDL and triglycerides should be monitored.

D is for a healthy diet and, if appropriate, drug therapy.

E is for exercise.

S is for stop smoking. Smoking doubles the risk of heart disease in people with diabetes.

Even when blood sugar levels are reasonably controlled, some inflammation in the blood vessels is likely. So ask about your risk of heart disease and stroke—even if your blood sugar levels are in check.

In addition, a healthy diet, regular exercise and certain medications that might be prescribed can protect your heart. Experts suggest:

• Adopt a heart-healthy diet, or eating plan.
  Eating fewer carbohydrates (especially simple carbohydrates such as table sugar and sweetened beverages that lack nutritional value) can help lower your body’s need for insulin and help regulate your blood sugar level.
• Ask about diabetes medications.
  These can help lower blood sugar levels, but it seems some of these medications can benefit the heart, too, especially in people with existing cardiovascular disease.

Drug Therapy

In addition to making healthier lifestyle choices every day, medications also can help manage diabetes. Your health care provider may recommend one or a combination of medications that are used to help lower:

• Blood sugar levels and keep them within a target range
• Cholesterol
• Blood pressure
• The risk of blood clots, heart attack or stroke
• Other cardiovascular risk factors

New Medications

Three diabetes medications that lower blood sugar levels—empagliflozin, liraglutide and and canagliflozin—were recently approved by the U.S. Food and Drug Administration to help reduce cardiovascular disease in people with diabetes and heart disease or at high risk for CV disease. In some cases, these medicines also have helped lower related deaths in these patients. But mounting data suggest these medicines may be protective even among those without heart disease.

Lower Your Heart Risk

You can change the course of your disease and lower your chances of developing heart-related problems in addition to diabetes. Be sure to talk with your health professional.

Here are some suggestions that may help:

❱❱ Quit smoking

• Ask for help.
• Call 1-800-784-8669 (1-800-QUIT-NOW).

❱❱ Commit to regular exercise

• Sitting for long periods of time, not exercising—or both—are harmful.
• Aim for 150 minutes of activity per week (just over 20 minutes a day).
• Housework, brisk walking, dancing, gardening, swimming and riding a bike are all good ways to stay active. Doing 10-minute bursts of activity at a time counts—and they add up!

❱❱ Choose a heart-healthy diet

• Talk with your health care team about a heart-healthy eating plan that also keeps your diabetes better controlled. For example, try to choose:
  • Non-starchy vegetables and fresh fruits
  • Whole-grain foods
  • Lean proteins
  • Low-fat milk and dairy products
  • Healthy fats (nuts, seeds, avocado and vegetable oils)
  • Foods low in sugar and simple carbohydrates
• Make good choices when eating on the go.
• Hold the salt.

❱❱ Maintain a healthy weight

• If you’re overweight, losing just 5% to 7% of your total body weight can improve your health.

❱❱ Know your numbers

• Keep track of your A1C, blood pressure and LDL-cholesterol and triglycerides, and work to keep them under control.
• Ask about cardiovascular risk calculators.

❱❱ Lower stress and get enough sleep

• Aim for seven or more uninterrupted hours of shut-eye a night.
• If you suspect you might have sleep apnea, talk with your doctor as this also can affect your heart health.

❱❱ Educate others

• Most people with diabetes don’t know about the relationship between type 2 diabetes and cardiovascular disease.
• Spread the word to empower others to take action for a healthy heart.