The Link Between Diabetes and Heart Disease
People with diabetes are twice as likely to develop heart disease due to factors such as high blood sugar, high cholesterol and high blood pressure.
By
Lindsay Cohen, RDN
| Published on February 11, 2025
5 min read
Lindsay Cohen, RDN
Credit: Mama-Betes

American Heart Month takes place every year in February. It is a month dedicated to raising awareness about heart disease and encouraging healthy habits. Common types of heart disease include coronary artery disease, heart attack, stroke and peripheral artery disease. People with diabetes are twice as likely to develop heart disease than the general population.
This article will review the reasons why those with diabetes have an increased risk of heart disease, as well as steps you can take to protect your heart if you are living with diabetes.
How Does Diabetes Increase Heart Disease Risk?
There are several reasons why diabetes can increase the risk of heart disease. Chronically high blood sugar levels act like sandpaper inside your blood vessels, causing tiny tears and inflammation. This damage makes the blood vessels more susceptible to plaque buildup, also known as atherosclerosis, which narrows the arteries and restricts blood flow. This can lead to a heart attack or stroke if blood flow to the heart or brain is blocked.
People with diabetes also have an increased risk of elevated cholesterol levels, leading to higher “bad” cholesterol (LDL) and lower “good” cholesterol (HDL).
High blood pressure (hypertension) is also prevalent in people with diabetes. Elevated blood pressure forces the heart to work harder, which can weaken the heart over time.
Other factors that increase the risk of heart disease include obesity; smoking; not getting enough physical activity; eating a diet high in saturated fat, trans fat, cholesterol and salt; and drinking too much alcohol.
Recognizing the Signs and Symptoms
Recognizing the signs and symptoms of heart disease is crucial for everyone, especially for those living with diabetes. In some cases, diabetes can mask the typical warning signs, which means you may not recognize that there is a serious problem.
Classic symptoms of a heart attack typically include chest pain or discomfort, shortness of breath or pain radiating to the arm or jaw. People with diabetes may experience “silent” heart attacks with less obvious symptoms such as unexplained fatigue or weakness, nausea or indigestion, dizziness or lightheadedness, or breaking out in a cold sweat.
Stroke symptoms often include facial drooping or numbness, arm weakness and speech difficulty. The acronym FAST helps to remember the common signs of a stroke:
- Facial drooping: One side of the face droops or feels numb.
- Arm weakness: Sudden weakness or numbness in one or both arms.
- Speech difficulty: Slurred speech, difficulty speaking or understanding.
- Time to call 911: If any of these symptoms appear, call for emergency medical help immediately.
Peripheral artery disease (PAD) is another common form of heart disease. PAD affects the blood vessels in the legs and feet, leading to pain or cramping in the legs or hips, especially during activity. It can also cause numbness or tingling in the feet or toes, sores or wounds on the feet that heal slowly, and cold feet or a noticeable difference in temperature between legs.
If you experience any of the symptoms mentioned above, make sure to seek medical attention.
Keeping Your Heart Healthy
The good news is that you can significantly reduce your risk of heart disease by keeping the following key points in mind:
- Heart-healthy, diabetes-friendly diet: Control portions and limit saturated and trans fats, cholesterol, sodium and added sugars.
- Regular physical activity: Even small amounts of activity can make a difference. Find activities you enjoy and make them a regular part of your routine.
- Stress management: Chronic stress can contribute to high blood pressure.
- Smoking cessation: Smoking significantly increases your risk of heart disease. Talk to your doctor about resources to help you quit.
- Regular doctor’s visits: See your doctor regularly for checkups and to monitor your blood sugar, blood pressure and cholesterol levels.
- Take medications regularly: Your doctor may prescribe medications to manage blood pressure, cholesterol and blood sugar to further reduce your risk.
- Empower yourself with knowledge: The more you know about diabetes and heart disease, the better you’ll be able to manage it effectively. Take advantage of free resources like American Diabetes Association (ADA) and American Heart Association (AHA).
Remember, by staying informed, actively managing your diabetes and adopting a heart-healthy lifestyle, you can significantly reduce your risk of developing heart disease.