Diabetes - Recognizing And Reducing Risk Factors: Heart Disease

Content provided by the Faculty of the Harvard Medical School

Diabetes

Diabetes is a chronic metabolic disorder characterized by elevated levels of blood sugar. Type 1 diabetes is an autoimmune disorder: A person's immune system attacks the pancreas, destroying the cells that produce insulin, which is needed to metabolize blood sugar. In type 2 diabetes, elevated blood sugar levels usually occur because a combination of poor diet, a sedentary lifestyle, and weight gain creates a condition known as insulin resistance: The pancreas produces insulin, but the body can't respond to it efficiently.

Both forms of diabetes increase the risk for heart disease, but people with type 2 diabetes — which is often accompanied by various cardiovascular risk factors such as high blood pressure, high cholesterol, elevated triglycerides, and obesity — are especially at risk. That is why an adult diagnosed with diabetes has the same high cardiac risk as someone who has already had a heart attack. But everyone with diabetes, regardless of type or when it was diagnosed, has reason for concern. Between 65% and 75% of people with diabetes can expect to die from some type of cardiovascular disease — a death rate that is two to four times that of people without diabetes.

While experts don't fully understand the causal relationship, it appears that the long-term elevated blood sugar and low-grade inflammation seen in diabetes damage the coronary arteries, speeding the process of atherosclerosis. Heart attacks and other cardiovascular problems are not only more common in people with diabetes, but they occur earlier in life and are more likely to be fatal than in people without diabetes.

So what do you do to protect yourself if you have diabetes? Like everyone at risk, practice a healthy lifestyle (see "Lifestyle changes to protect yourself"), control blood pressure, watch your weight, and keep cholesterol levels within normal limits (see sections that follow).

Last updated:	May 03, 2007