Diabetes & Heart Health: Can High Blood Sugar Affect Your Heart?

Written by Reshma Pathare on Tue, 01 August 2023

Key Highlights

  • According to the American Diabetes Association, heart disease is the number one killer of people with diabetes.
  • If a heart attack occurs, the risk of death is much greater for the person with diabetes.
  • People with diabetes commonly don't get chest pain when they have a heart attack due to nerve damage.

The heart is a key organ that can be affected by diabetes.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), having diabetes means you are more likely to develop heart disease.

Lifestyle Management

People with diabetes are also more likely to have certain risk factors, such as high blood pressure or high cholesterol, that increase their chances of having a heart attack or a stroke.

Diabetes & heart-related complications

Complications can develop if your blood glucose remains high over many years. Says the American Diabetes Association, heart disease is the number one killer of people with diabetes. That's why, it is important to understand and mitigate the risk of cardiovascular disease and stroke.

  • People with diabetes are at least twice as likely to have heart disease or a Stroke.
  • People with diabetes tend to develop heart disease or have strokes at an earlier age than other people.
  • Heart attacks in people with diabetes are more serious and more likely to cause Death.
  • One of every three people with diabetes over 50 is thought to have peripheral arterial disease (PAD).

Risk factors

According to the Center for Disease Control and Prevention (CDC), over time, high blood sugar can damage blood vessels and the nerves that control your heart.

People with diabetes are also more likely to have other conditions that raise the risk for heart disease:

High blood pressure

  • High blood pressure not only increases your risk for heart disease but also increases your risk for other diabetes complications.
  • It can damage small blood vessels and capillaries, especially in the eyes and kidneys.
  • People with diabetes need to be especially careful to control their blood pressure because of the potential damage to blood vessels and tissues.
  • The recommended blood pressure for most people with diabetes is less than 130/80mmHg.

High triglycerides and low HDL cholesterol

  • High triglycerides, which is a type of fat in your blood and low HDL or good cholesterol is contributes to hardening of the arteries.
  • Excess of LDL (bad) cholesterol in your bloodstream can form plaque on damaged artery walls.
  • In short, abnormal cholesterol levels can raise your risk of heart disease.

Obesity and abdominal fat

  • Being overweight or having abdominal fat can make it harder to manage your diabetes and raise your risk for heart disease and high blood pressure.
  • In fact, excess belly fat around your waist, even if you are not overweight, can raise your chances of developing heart disease.

Chronic kidney disease (CKD)

  • Heart disease is closely linked with chronic kidney disease, a condition in which your kidneys are damaged and can't filter blood the way they should.
  • Having diabetes is a risk factor for developing kidney disease, which affects about 40% of people with diabetes.
  • Other risk factors are high blood pressure and a family history of kidney failure.

The cardiovascular damage caused by diabetes

Peripheral Arterial Disease (PAD)

  • Another serious problem for people with diabetes is PAD.
  • Blockage of blood flow to the feet puts your feet at risk for amputation.
  • One of the symptoms of PAD is intermittent claudication. The leg arteries become blocked and painful. The pain comes and goes.

Coronary Artery Disease (CAD)

This is the most common reason for fatalities in people with type 2 diabetes. The risk factors are:

  • Abnormal blood fats, especially reduced HDL and increased triglyceride. People with impaired glucose tolerance show these abnormalities.
  • Central adiposity, abdominal fat.
  • Hypertension.
  • Obesity, often due to lack of exercise and a high-fat diet.

Gestational diabetes and future risk

  • According to the Heart Foundation, Australia, most women who have had gestational diabetes during their pregnancy will no longer have diabetes after their baby is born.
  • They are however, at greater risk of developing type 2 diabetes, heart disease and stroke compared to women who have not had this condition.
  • If you have experienced gestational diabetes, talk to your doctor about monitoring your heart health and managing your ongoing risk.

Diabetes & Heart Attack

If a heart attack occurs, the risk of death is much greater for the person with diabetes. A significant percentage of people with diabetes die from coronary heart disease as compared to those who don't have diabetes.

If your glucose control is poor, then the death rate is worse. You may then have more complications, such as heart failure, from a heart attack than the person without diabetes.

Warning signs

  • chest pain or discomfort, tightness, pressure, or fullness. This might feel like indigestion or heartburn.
  • discomfort in one or both of your arms, your back, jaw, neck, or stomach
  • shortness of breath
  • sweating
  • indigestion or nausea or vomiting
  • tiredness, fainting, or feeling light-headed

You may not have all of these signs, and they may come and go. Women are more likely to have some of the other warning signs.

How are the signs of a heart attack different for people with diabetes

Says the American Diabetes Association (ADA), diabetes can affect your nerves and make heart attacks 'silent'.

A silent heart attack means that you may not have any warning signs, or they may be very mild.

People with diabetes commonly don't get chest pain when they have a heart attack due to nerve damage and this may be one reason why people may not get the treatment they need when they need it.

Once a heart attack occurs, the outlook is much worse for the person with diabetes. The treatment options are the same for people with or without diabetes.

Here are a couple of things to keep in mind:

Manage your ABCs

  • Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
  • Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
  • Manage your cholesterol levels.

Tips for starting medication

  • Watch for changes in your blood glucose levels.
  • Start new medicines one at a time, if possible; some medications can interfere with the breakdown, absorption, and removal of other medicines.
  • Know that many kinds of medications may have side effects may occur; report anything unusual to your doctor.

Nutrition to manage diabetes & heart disease

Everyone with diabetes should see a registered dietitian and have regular reviews for specific advice on their eating habits.

The food choices you make and your eating habits are really important in helping to manage the condition, avoid cardiovascular risks and improve long-term health.

Diabetes and heart health

Here are some top tips for eating well with to manage both diabetes and heart issues:

Eat three meals a day. Don't skip meals and space your breakfast, lunch and evening meal out over the day. This will help control appetite and blood glucose levels.

Cut down on fat, particularly saturated fats. Cut down on butter, margarine and cheese and try grilling, steaming and oven baking instead of frying. Trans fats reduce insulin sensitivity.

Choose the right fats. Include, in your diet, mono-unsaturated and polyunsaturated fats that help to lower LDL (bad) cholesterol. Examples include, sesame seeds, pumpkin seeds, cold pressed olive oil, sunflower seeds, almonds, walnuts, brazil nuts, avocadoes. sunflower oil.

Reduce salt intake. More than 6g of salt in a day can raise blood pressure, which can lead to stroke and heart disease. Limit the amount of processed foods and try flavouring food with herbs and spices instead of salt.

Eat more fruit and vegetables. Aim for at least five portions a day to provide you with vitamins, minerals and fibre to help balance an overall healthy diet.

Include more beans and lentils. They have less of an effect on blood glucose levels and may help to control blood fats.

Aim for at least two portions of oily fish a week. Oily fish such as mackerel, sardines, salmon and pilchards contain omega 3, which helps protect against heart disease.

Limit sugar and sugary foods. This does not mean a sugar-free diet. Sugar can be used in foods but using sugar-free, no added sugar, or diet fizzy drinks/squashes, instead of sugary versions is an easy way to reduce intake.

Drink alcohol in moderation. Alcohol contains empty calories so cutting back can also help in losing weight. Alcohol can make low blood glucose levels more likely with certain diabetes medication so it is advisable not to drink on an empty stomach.

Avoid diabetic foods and drinks. They offer no benefit to people with diabetes. They will still affect blood glucose levels, contain just as much fat and calories as the ordinary versions, can have a laxative effect and are expensive.

Quit the fizzies and sugar-laden fruit juices. Cut out fructose, which occurs in soft drinks and many food products.

Include protein. Ensure you have a source of protein at each meal such as meat, fish, poultry, milk, pulses, (unsalted) nuts, seeds or eggs. Protein is converted into glucose at a slower rate than carbohydrates, and has little effect on blood sugar levels

Select foods that only gradually raise blood sugar levels. Have low to medium Glycaemic Index foods which include, apples, pears, berries, sweet potatoes, pulses, whole grains, brown rice, natural muesli, porridge, wholemeal bread, wholemeal pasta, basmati rice, noodles.

Experiment by testing your blood sugar levels. Test before a meal or snack, 2 hours after and finally 4 hours, to observe the effect of that food. Some low GI foods may need to be tested up to 6 hours after to experience the effect of the snack or meal.


Like most complications of diabetes, the heart complications develop gradually and show no symptoms in the early stage. That is why it is important to regularly monitor your cardiovascular functions through cardiac tests in order to check for any complications and to limit their aggravation.

An improved lifestyle will lower both your risk of diabetes as also heart disease.


Reshma Pathare

Reshma Kulkarni-Pathare has been a self-employed media professional since 1999. Starting off as a Freelance Journalist for Times of India Thane Plus, Reshma went onto write for more than 45 national and international publications including Times of India, New Woman, Femina, Indian Express, The Hindu, BBC Good Homes and many more. While her forte has been lifestyle writing, she is equally proficient in writing health articles. Her health articles have been published in Health International (Dubai), New Woman, Femina, and Mother & Baby.

Apart from being a journalist, Reshma also works as a copy-editor for self-publishing houses and academic journals.

She is an award-winning bi-lingual translator with more than 12 books published in her name.

She has been a Visiting Faculty Member for post-graduate department of mass media at MET College (Mumbai) and Welingkar WeSchool (Mumbai).

She has worked as a Consumer Marketing Insights Researcher for global organizations like CEB Iconoculture (USA) and Gartner (USA).

Consolidating her multifarious skills in the media, in 2021, Reshma launched her own boutique media agency called Talking Turkey Communications, which specializes in content writing, editing, and translation.

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