Heart disease is common in people with diabetes. Data from the National Heart Association from 2012 shows 65% of people with diabetes will die from some sort of heart disease or stroke. In general, the risk of heart disease death and stroke are more than twice as high in people with diabetes.

While all people with diabetes have an increased chance of developing heart disease, the condition is more common in those with type 2 diabetes. In fact, heart disease is the number one cause of death among people with type 2 diabetes.

 Aside from diabetes, other health problems associated with heart disease include high blood pressure, smoking, high cholesterol levels, and a family history of early heart disease.

The more health risks factors a person has for heart disease, the higher the chances that they will develop heart disease and even die from it. Just like anyone else, people with diabetes have an increased risk of dying from heart disease if they have more health risk factors. However, the probability of dying from heart disease is 2 to 4 times higher in a person with diabetes.

Heart disease experts recommend that all people with diabetes have their heart disease risk factors treated as aggressively as people who have already had heart attacks.

The most common cause of heart disease in a person with diabetes is hardening of thecoronary arteries or atherosclerosis, which is a buildup of cholesterol in the blood vessels that supply oxygen and nutrition to the heart.

When the cholesterol plaques can break apart or rupture, the body tries to repair the plaque rupture by sending platelets to seal it up. Because the artery is small, the platelets could block the flow of blood, not allowing for oxygen delivery and a heart attack develops. 

Not only are people with diabetes at higher risk for heart disease, they're also at higher risk for heart failure, a serious medical condition in which the heart is unable to pump blood adequately. This can lead to fluid build-up in the lungs that causes difficulty breathing, or fluid retention in other parts of the body (especially the legs) that causes swelling.

The common symptoms of a heart attack include,

• Shortness of breath.
• Feeling faint.
• Feeling dizzy.
• Excessive and unexplained sweating.
• Pain in the shoulders, jaw, and left arm.
• Chest pain or pressure (especially during activity).
• Nausea.

Remember not everyone has pain and these other classic symptoms with a heart attack. 

*If you are experiencing any of these symptoms, you should call your doctor, call 911, or go to the nearest emergency room immediately.

Stroke and Peripheral vascular disease are also common in people with diabetes. 

The best way to prevent heart disease in people with diabetes:

• Keep your blood sugar as normal as possible.
• Control your blood pressure, with medication if necessary. The target for people with diabetes is under 130/80.
• Get your cholesterol numbers under control. You may need to take medication to do this.
• Lose weight if you are obese.
• Ask your doctor if you should take an aspirin a day.

Low-dose aspirin therapy is recommended for men and women with types 1 or 2 diabetes who are over age 40 and areat high risk for heart disease and peripheral vascular disease. Talk to your doctor to determine if aspirin therapy is right for you. If you have certain medical conditions, aspirin therapy may not be recommended.

• Exercise regularly.
• Eat a heart-healthy diet such as the Mediterranean diet or DASH diet.
• Quit smoking.
• Work to reduce daily stress.

SOURCES: American Diabetes Association: “Fasting and After-Meal Glucose Levels and Cardiovascular Disease.” The Framingham Heart Study: “Profile of the Framingham Heart Study.” UpToDate: Patient Information: “Treatment of hypertension in diabetes mellitus.” American Heart Association: “Diabetes and Cardiovascular Disease.” Vakkilainen, J, Circulation, 2003; 107:1733. Otvos, J.  Circulation, 2003; 108 (Suppl IV): 740.