Keeping Your Heart Healthy: A Guide for Individuals with Diabetes

Diabetes is a condition that affects millions of people worldwide, and its prevalence is on the rise. While managing blood sugar levels is a top priority for people with diabetes, it's equally essential to focus on heart health. 

What is diabetes?

Diabetes is a condition characterized by high blood glucose (or “blood sugar”) levels. Glucose comes from the food we eat. It is also produced by our liver. Glucose is the main source of energy for the body’s cells and is transported through the bloodstream.

For our cells to use glucose, it needs to first enter our cells. Insulin is a hormone that is produced by our pancreas and it acts like a “key” to help glucose enter our cells.

Diabetes happens when our body either doesn’t make enough insulin (i.e. defect in insulin secretion), and/or it doesn’t use insulin well (i.e. insulin resistance). Without insulin, the cell remains locked, and glucose can’t get inside. The glucose remains in our blood and causes the high blood glucose (also known as high blood sugar) that we see in diabetes!

Types of diabetes

There are several types of diabetes:

• Type 1 diabetes occurs when the body is unable to produce insulin. It can occur at any age, although it typically presents more commonly in children and young adults. Different factors, including genetics and some viruses, may contribute to type 1 diabetes.

• Type 2 diabetes occurs when the body does not produce enough insulin or when the insulin produced does not work properly. Those at risk for type 2 diabetes are more likely to encounter problems with their heart and arteries, making it imperative to adopt a heart-healthy lifestyle. 

• Gestational diabetes occurs when hormones produced during pregnancy cause our cells to be more resistant to insulin. Gestational diabetes increases the risk of complications during pregnancy and increases the risk of developing type 2 diabetes for both mother and baby. Research found that women with gestational diabetes were at higher risk for cardiovascular diseases, whether or not they developed type 2 diabetes later in life. 

• Pre-diabetes is a condition where your blood glucose (sugar) level is higher than normal, but it’s not high enough to be considered diabetes. It is a warning sign for type 2 diabetes. Research has shown that about 70% of people with pre-diabetes will develop type 2 diabetes over time. With lifestyle changes, it is possible to prevent pre-diabetes from developing into type 2 diabetes.

What is a heart disease?

There are different types of heart diseases – problems that affect your heart. Though the most common cause of heart disease is narrowing or blockage of the blood vessels that supply blood to the heart – this is called a coronary artery disease and this happens gradually over a period of time. Other kinds of heart problems may happen to the valves in the heart, or the heart may not pump well and cause heart failure.

The term “cardiovascular disease” includes all types of heart disease, stroke, and blood vessel disease.

The Link Between Heart Health and Diabetes

Diabetes and heart health are closely intertwined. People with diabetes, especially those with poorly controlled blood sugar levels, are at a higher risk of heart-related complications. Cardiovascular disease, including heart attack and stroke, is the main cause of death among people with diabetes.

These are just a few of the key mechanisms and factors that link diabetes and heart disease:

Insulin Resistance

Many individuals with type 2 diabetes have insulin resistance, a condition where their body's cells don't respond effectively to insulin. Insulin resistance can contribute to the accumulation of glucose in the bloodstream, leading to elevated blood sugar levels. This chronic hyperglycemia can damage blood vessels and increase the risk of atherosclerosis (hardening and narrowing of arteries), which is a hallmark of heart disease.

High Blood Sugar Levels

Prolonged high blood sugar levels, a characteristic of poorly controlled diabetes, can directly damage the endothelium (the inner lining of blood vessels). This damage can cause inflammation and promote the formation of fatty deposits in the arteries, leading to atherosclerosis.

High Blood Pressure

Diabetes is associated with an increased risk of hypertension (high blood pressure). High blood pressure is a significant risk factor for heart disease as it can strain the heart, damage blood vessels, and increase the risk of heart attacks and strokes.

Abnormal Blood Lipids

Diabetes often results in abnormal lipid profiles, including elevated triglycerides and low levels of high-density lipoprotein (HDL) cholesterol. These lipid abnormalities contribute to the development of atherosclerosis.

Obesity

Obesity is a common factor in both diabetes and heart disease. Excess body weight, particularly visceral fat (fat around the abdomen), can exacerbate insulin resistance, elevate blood pressure, and increase the risk of heart disease.

Inflammation

Diabetes is associated with chronic low-grade inflammation throughout the body. Inflammation plays a key role in the development and progression of atherosclerosis and other heart-related issues.

Metabolic Syndrome

Many individuals with type 2 diabetes also have metabolic syndrome, a cluster of conditions that includes obesity, high blood pressure, abnormal lipid profiles, and insulin resistance. Metabolic syndrome substantially elevates the risk of heart disease.

If you have diabetes, you can protect your heart and health by managing your blood glucose, also called blood sugar. You can also protect yourself by controlling your high blood pressure and high cholesterol. If you smoke, get help to stop.

Why Heart Health Matters

Given the link between diabetes and heart diseases, here are a few reasons why heart health matters, especially for people with diabetes:

Increased Risk of Cardiovascular Disease

Individuals with diabetes are more susceptible to cardiovascular diseases such as heart attacks, strokes, and high blood pressure. These conditions are often a result of elevated blood sugar levels and insulin resistance, which can lead to the narrowing and hardening of arteries.

Silent Symptoms

Individuals with diabetes may experience "silent" symptoms, meaning they might not feel the warning signs of a heart problem until it's advanced. This makes regular heart health monitoring crucial, as early intervention can be life-saving.

Kidney and Eye Complications

Heart health is closely linked to kidney function and eye health. Diabetics can develop kidney problems and vision loss, both of which are complications associated with cardiovascular issues.

Enhanced Risk Factors

Diabetes can contribute to other risk factors for heart disease, such as obesity, high cholesterol, and high blood pressure. Managing these risk factors becomes vital in maintaining overall heart health.

How to Test for Heart Disease

Through a comprehensive health screening, including a vascular and heart screening, as well as blood pressure, weight and cholesterol levels assessment, your doctor will help you understand your overall risk for heart disease. 

You may also be recommended other tests to check your heart health, including:

• An electrocardiogram (ECG). This test can detect abnormal heart rhythms, which are an indicator of heart problems. Using sensors placed on the surface of the chest, the electrical activity of the heart is evaluated.  

• Treadmill cardiac stress test. This test evaluates your heart’s ability to tolerate increased activity due to exercise and can help to detect ischaemic heart disease. 

• 2D Echocardiogram. This is an ultrasound of your heart, which uses sound waves to evaluate the structure and function of your heart.

Book a NOVI Health Assessment appointment which includes:

• Base screening panel covering more than 50 health parameters.

• Pre-screening consultation with a doctor to evaluate your health and recommend relevant screening tests. 

• Post screening review by a specialist doctor providing an in-depth review of your results.

• Hardcopy or PDF screening report.

How to Keep Your Heart Healthy

Maintaining a healthy heart while living with diabetes requires a proactive and holistic approach. Here are a few lifestyle changes and monitoring tips that can can help lower your risk for heart disease or keep it from getting worse

1. Monitor Blood Sugar Levels

Be consistent in monitor your blood sugar levels to keep them within a target range as recommended by your healthcare provider. Doing this will reduces the risk of complications that can impact your heart.

2. Eat a Heart-Healthy Diet

Go for a diet that is rich in fruits and vegetables. Fruits and vegetables are rich in dietary fibre, vitamins and minerals which can lower the risk of developing heart disease and stroke. The fibre content also helps in blood sugar control by slowing the digestion and absorption of the meal into the bloodstream. Reduce consumption of refined carbohydrates, especialy those with added sugars. Refined carbohydrates include white bread, white rice, noodles, pastries and drinks and foods with added sugars such as soft drinks, juices, bubble tea, chocolate, ice-cream, cakes. These foods generally have a high glycemic index, and are broken down quickly in the body, causing blood sugar levels to spike after consumption. Drink more water, fewer sugary drinks, and less alcohol.

This approach can help control blood sugar and reduce the risk of heart disease.

3. Exercise Regularly and Maintain a Healthy Weight

Be active! Engage in regular physical activity to improve your heart health. Exercise has been proven to induce positive changes in your cholesterol profile, reduce blood pressure and improve other cardiovascular risk factors – as well as keeps your weight under control.

Ideally, adults with diabetes should engage in 150 min or more of moderate-to-vigorous intensity activity weekly, spread over at least 3 days/week, with no more than 2 consecutive days without activity. Shorter durations (minimum 75 min/week) of vigorous-intensity or interval training may be enough for younger and more physically fit individuals. However, remember to consult your doctor before starting any new exercise routine.

In addition, aim for a healthy weight. If you’re overweight, losing even a modest amount of weight can lower your triglycerides and blood sugar.

4. Manage Stress

Chronic stress can affect blood sugar levels and increase the risk of heart problems. Practice stress-reduction techniques such as meditation, yoga, or deep breathing exercises to help manage stress.

5. Quit Smoking

Smoking is a significant risk factor for heart disease. If you smoke, seek support to quit, as it can dramatically improve your heart health. Studies have shown that smoking is a risk factor for heart diseases in diabetes and hypertension.

6. Take Medications as Prescribed

If your healthcare provider prescribes medications to help keep your blood sugar, blood pressure, cholesterol, and triglycerides close to your target levels, remember to take them as directed and follow your diabetes treatment plan. Medications can help control blood sugar and reduce the risk of heart complications.

A Holistic Approach to Managing Your Diabetes and Heart Health

NOVI’s diabetes treatment program, NOVI Magnum, uses an approach that is tailored to your unique circumstances, lifestyle, and needs. Here’s how the program works:

1. You will have your very own care team

You will have your own care team – a specialist doctor and health coach – who will take the time to understand your goals, health status, including your heart health, and current lifestyle. They will work together with you to create a holistic, personalized treatment plan that best suits your unique situation.

2. You will use technology for you and your care team to understand your body better

You will be provided with a continuous glucose monitor (CGM) to help monitor your blood sugar. By logging your food intake and physical activity, you and your care team will understand your body better. 

3. You will get continuous support remotely. 

In fact, your care team is with you, even when you step out of the clinic. Whether you want to eat better or exercise more, your coach will create an evidence-based, step-by-step program based on your preferences. And the best part about this is that you will get continuous messaging support and reviews by your coach and doctor remotely.

Learn more about our diabetes treatment program.