People with diabetes have about twice the risk of developing a cardiovascular disease such as CHD compared with people who don’t have the condition.
Cases of CHD are particularly high in the UK’s South Asian community, where type 2 diabetes is over six times more common than among white people.
How diabetes affects your heart
There’s a lot that people with diabetes can do to reduce their risk of CHD. “A healthy lifestyle can reduce the risk substantially,” says Katharine Greathead of Heart Research UK.
Diabetes happens when the level of sugar (glucose) in your blood is too high because your body is unable to use it properly. High levels of glucose in your blood can lead to the build-up of fatty deposits in the arteries around your heart.
Diabetes worsens the harmful effects of smoking, high blood pressure and high cholesterol on your heart.
Your GP or diabetes care team will work out your risk of developing CHD, and may prescribe medicines to reduce that risk. As part of your regular check-ups, they will monitor the things that increase your chance of CHD, such as your body mass index (BMI), blood pressure and cholesterol.
However, medicine alone won’t prevent CHD. The factors that put you at risk of CHD need to be controlled through a combination of medical treatment and a healthy lifestyle.
Smoking is a major cause of CHD. If you also have diabetes, the damage to your arteries is increased. “Smoking is a risk factor in its own right,” says Greathead. “If you have diabetes and smoke, you’re not simply adding another risk, you’re multiplying your overall risk of heart disease.”
Physical inactivity puts people with diabetes at risk of CHD. Adults should aim for 150 minutes of moderate aerobic activity every week.
If you’re just starting off, build up the frequency of your activity gradually. “The activity should leave you feeling warm and slightly out of breath, but still able to hold a conversation,” says Greathead.
Moderate, rhythmic exercise – such as brisk walking, cycling or swimming – provides the level of intensity that will benefit both your heart and diabetes.
Regular exercise will benefit your general health, and it may help reduce the amount of tablets or insulin you need to take.
Before exercising, Greathead recommends people with diabetes get advice from their diabetic nurse or doctor. “People with diabetes will have different requirements,” she says.
“Some may be on medication; others may be on a special diet. The way to do it is to include activity in your everyday life and make sure it’s something you enjoy doing.”
“An active lifestyle and a healthy diet will help to reduce the build-up of fatty deposits in your arteries,” says Greathead.
A healthy, balanced diet is low in fat, particularly saturated fat, which is contained in fatty meat, cakes, full-fat dairy products, ghee, and coconut and palm oil.
Use olive oil or rapeseed oil for cooking instead, as this can help lower your cholesterol level. Most people with diabetes need to take cholesterol-lowering statins as well.
Also cut down on sugary food and drink so you have them only occasionally, in small amounts. Many foods and drinks with added sugars contain a lot of calories (or kilojoules), so eating them too often can lead to weight gain. Swap sugary drinks for “no added sugar” or “diet” equivalents to help reduce your sugar intake.
Eat plenty of fibre – aim for at least 30g a day. Eat fibre from a variety of sources, such as wholemeal bread and wholegrain cereals, and at least five portions of a variety of fruit and vegetables a day.
For most people with diabetes, the goal is to have a blood pressure reading of 140/80mmHg or below, but this goal may be different, depending on your individual case.
This can be achieved through weight management, physical activity, and cutting down on alcohol and salt. Most people need to take medicines as well.
Managing your weight
If you’re overweight, losing weight will help lower your blood pressure and cholesterol levels, and help control your diabetes.
Use the healthy weight calculator to find out if you’re a healthy weight. It will also give you personalised information and advice based on your results.