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Jim was 42 when his doctor told him that he had type 2 diabetes. "I hadn't been feeling that great for a while, but when my doctor found that my blood pressure was high, he decided to test me for diabetes, too."
It was quite a shock for Jim, but his doctor explained to him that being over 40 and having high blood pressure increased his risk for diabetes. "As soon as my doctor diagnosed diabetes, he made sure I was doing everything I could to manage it, and to control my blood pressure.
I had no idea that if I had diabetes that I could have heart disease, too."
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More than two million Canadians have diabetes and the number is expected to rise to three million by 2010.
Diabetes is a leading cause of death by disease – and heart disease is one of the major reasons why. According to the Canadian Diabetes Association, people with diabetes are two to four times more likely to get heart disease than people who don't have diabetes.
The relationship between heart disease and diabetes is so serious that four out of five people with diabetes will die of heart disease.
Diabetes and heart disease: what's the link?
Although we don't know exactly why people with either type 1 or type 2 diabetes are more likely to develop heart disease,
research has found that when high blood glucose levels are not managed well, this can cause damage to the coronary arteries.
People with diabetes can also have high levels of insulin that can contribute to the development of fatty deposits or plaque in the arteries.
Coronary artery disease, or hardening of the arteries, is the most common form of heart disease in diabetics.
"In Canada, four out of five people who have diabetes will die of heart disease."
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People living with diabetes are also more likely to have conditions related to heart disease such as:
- high blood pressure.
- high levels of bad cholesterol (LDL) and other fats in their blood – which often has no symptoms.
- low levels of good cholesterol (HDL) – the cholesterol that helps reduce the risk of heart disease.
- a thicker left heart ventricle, which can affect how well the heart pumps.
Being overweight is also a risk factor for heart disease, and 80 to 85% of people with type 2 diabetes are overweight.
Additional risks
The risk of heart disease increases even more if the diabetes is poorly managed. Family history and lifestyle factors, like smoking and being physically inactive, also contribute to the risk.
Poorly managed diabetes can result in abnormal cholesterol levels and high blood glucose levels.
Heart disease is even more of a risk for people living with type 1 diabetes, because glucose levels can be harder to manage than for those who have type 2 diabetes.
Type 1 diabetes is also more likely to be diagnosed at a younger age, giving heart disease a chance to develop over a lifetime.
Symptoms of diabetes may go unnoticed for about seven years—or until there is a problem
Of the two million Canadians who have diabetes at least one-third don't even know it.
The
symptoms of diabetes are often silent and it's not until a complication, often heart disease, happens that a diagnosis is made.
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40 or older?
Get tested for diabetes!
If you are 40 years or older, regular testing for diabetes is important.
It helps to ensure that diabetes is diagnosed early so that there is time to make the important lifestyle changes that can help to prevent heart disease.
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Good diabetes management: a three-way approach
Making the lifestyle changes that can reduce the impact of these risk factors is very important to delay or prevent heart disease.
Dr. Brian Rodrigues, Chair of the Canadian Diabetes Association National Research Council,
has spent many years researching the relationship between diabetes and heart disease.
In his research, he has seen the serious effects that result from poor management of diabetes.
"Good management of your diabetes and good control of your blood glucose levels are very important, but they're not enough.
To avoid the most serious complication of diabetes – heart disease – you must also manage your lipids and fats."
Three important aspects of diabetes management can reduce the risk of heart disease for a person with diabetes:
- Control blood glucose levels
It is very important that people with diabetes keep their blood glucose levels close to their target range.
- Control high blood pressure
People with diabetes should have their blood pressure checked by their healthcare provider at every diabetes-related visit.
- Lower high cholesterol
People with diabetes should be tested every one to three years to make sure that their cholesterol, lipids and other fats in the blood are normal.
People who are being treated with medication to control cholesterol should be tested more often.
Make preventing
heart disease a priority
Diabetes and heart disease is a serious combination. Reducing the risk of heart disease should be a priority for anyone living with diabetes.
Fortunately, good diabetes management can reduce risks of all of the complications of diabetes, including the most serious—heart disease.
As Jim says:
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"Now I take my blood pressure medicine, and I keep my blood glucose levels under control by eating better and walking as much as I can.
One thing I've learned from my diabetes is not to let it control me – if I manage my diabetes well then I can prevent having heart disease!"
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This article was written by the 
