As we continue our series A guide to a Healthy Heart we want to talk about diabetes and the role it can play in heart disease and strokes. Cardiovascular disease is the cause of death in over 65% of people who have diabetes. Diabetic women are especially at high risk of dying of heart disease or stroke.

There are about 14 million people in the U.S. that have been diagnosed with diabetes and nearly 6 million more that do not know they have it.

Diabetes Infographic

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Type 2 Diabetes

Type 2 diabetes most commonly develops in adulthood. With type 2 diabetes the pancreas still makes insulin but the body is not able to use properly. Gradually the pancreas loses its ability to produce insulin. This is a serious disease that requires care and management by both you and your healthcare team. Beside the increased risk of heart disease, it is the number 1 cause of blindness, kidney failure and lower limb amputation in adults. Diabetes can make it difficult to fight infections and can lead to nerve damage.

The risk for type 2 diabetes increases after age 45, but it is on the rise among both children and adults. Being overweight, especially have extra weight around the waist is a major risk factor of type 2 diabetes.

Physical inactivity and a family history of diabetes are also risk factors as is ethnicity. Type 2 diabetes is more common among African Americans, Native Americans, Hispanic Americans, Asian Americans, and Pacific Islanders. Also, women who have given birth to a baby weighing more than 9 pounds or experience gestational diabetes (diabetes during pregnancy) are more likely to develop type 2 diabetes later in life.


Diabetes has some common symptoms that you should be aware of if you have any risk factors. Fatigue, nausea, frequent urination, unusual thirst, weight loss, blurred visions, frequent infections and slow healing or sores can be symptoms of type 2 diabetes. If you are overweight or have any of the risk factors for type 2, even if you do not have any symptoms, you should talk to your doctor about getting tested. Is your fasting blood glucose level above 126 mg/dl? If so, you have diabetes.

Controlling your blood sugar (blood glucose) levels will help prevent many of the complications associated with diabetes. Because of the strong link between heart disease and diabetes it is important to keep certain heart disease risks under control. Your blood pressure, cholesterol has lower recommended levels if you have diabetes. Physically activity, no smoking and if you doctor recommends it, taking an aspirin daily may help prevent heart disease if you have diabetes.


You many not have diabetes now, but are at high risk for developing the disease if you blood glucose levels are higher than normal but not above 126 mg/dl. You are considered prediabetic if your fasting blood glucose level is 100-125 mg/dl. If you are diagnosed with prediabetes you may be able to prevent or delay the development of the disease by making modest changes. We will discuss some changes that may help later in this article under Preventing Diabetes.

Even though you may be “only prediabetic” you still are at greater risk of having a heart attack or stroke. Compared to people with normal blood glucose levels your risk is 50% greater of a heart attack or stroke. As a prediabetic you will need to pay attention to your blood pressure, blood cholesterol and other risk factors for heart disease and take steps to control those risks.

The ABCs of Diabetes Control

Diabetes and Heart Disease - A1C There are three important steps you can take to lower your risk of a heart attack or stroke if you have diabetes. Called the ABCs:

A is for A1C test, which is short for hemoglobin A1C. This test measures your average blood glucose over the last 3
months. It lets you know if your blood glucose level is under control. Get this test at least twice a year. Number to aim for: below 7.

B is for blood pressure. The higher your blood pressure, the harder your heart has to work. Get your blood pressure.
measured at every doctor’s visit. Numbers to aim for: below 130/80 mmHg.

C is for cholesterol. LDL, or “bad” cholesterol, builds up and clogs your arteries. Get your LDL cholesterol tested at
least once a year. Number to aim for: below 100 mg/dL. If you have both diabetes and heart disease, your doctor may advise you to aim for a lower target number, for example, less than 70.

Talk to your healthcare team and ask these three questions:

  1. What are my ABC numbers?
  2. What should my ABC target numbers be?
  3. What actions should I take to reach my ABC target numbers?

Diabetes and Heart Disease - Walking Lower Your Risk

To lower your risk of heart attack and stroke, also take these steps:

  • Be physically active every day.
  • Follow your doctor’s advice about getting physical activity every day.
  • Eat less salt and sodium, saturated fat, trans fat, and cholesterol.
  • Eat more fiber. Choose fiber-rich whole grains, fruits, vegetables, and beans.
  • Stay at a healthy weight.
  • If you smoke, stop.
  • Take medicines as prescribed.
  • Ask your doctor about taking aspirin.

Preventing Diabetes

As previously discussed, you are more likely to develop type 2 diabetes if you have a fasting blood glucose level of 100-125mg/dl. Taking steps now to improve your health can delay or possibly even prevent diabetes. Recent studies have shown that many overweight and prediabetic people have greatly reduced their risk of diabetes by doing just these 4 things (3 if you do not smoke).

  1. Lower fat diet
  2. Reduced calorie diet.
  3. 30 minutes of physical activity at least 5 days per week
  4. If you smoke – QUIT!

Diabetes and Heart Disease - Healthy DietThe following are some encouraging results of the study:

  • Overall, people who achieved a 5- to 7-percent weight loss (about 10 to 15 pounds) through diet and increased physical activity (usually brisk walking) reduced their risk of diabetes by 58 percent over the next 3 years.
  • For people over age 60, these lifestyle changes reduced the risk of developing diabetes by 71 percent.
  • Benefits were seen in all of the racial and ethnic groups that participated in the study—White, African American, Hispanic, American Indian, Asian American, and Pacific Islanders.
  • People taking the diabetes drug metformin (Glucophage) reduced their risk of developing the disease by 31 percent.

These findings suggest that you can act to prevent or delay diabetes, even if you are at high risk for the disease. For
more information on how to choose and cook low-fat foods, get more physical activity, and achieve a healthy weight visit our library of articles or talk to your healthcare providers.

Dr. Bobish

Dr. Bobish and her team’s goal is to help you reduce your risk of heart disease. Helping you to understand your risk factors and make healthful lifestyle changes.

Remember regardless of age or current state of health it is never too late to start protecting your heart. It is also never too soon and the sooner you act the better. Follow us on Facebook to see our latest post helping to keep you heart healthy. You can also explore all our articles that offer diet and exercise tips, recipes and information on procedures and heart disease.

Dr. Bobish and her team focus on preventative care and are here to support you. Alpine Cardiology provides patients with education as well as compassionate care and treatment. We are committed to keeping you healthy and heart smart! Request an appointment at 989-448-7002

Guide to a Healthy Heart

We are committed to keeping Northern Michigan healthy and heart-smart!

Over the next several months we will be publishing a series of articles that will become A Guide to a Healthy Heart. By breaking these guidelines into chapters we are able to offer more in depth information on the topics. Watch our Facebook page or website for the latest article.

Alpine Cardiology’s goal is to give you a better understanding of how to live a healthy lifestyle and to take care of your heart. To take the mystery out of what the tests are and what they mean. To encourage you to talk to your healthcare provider about your risk factors and how to reduce your risk. The more you know and understand the more likely you are to be successful in reducing risk and having a healthier lifestyle.

Links to published chapters are below if you would like to explore the guide more.

  1. Why should I care about heart disease?
  2. Heart Disease – What you need to know
  3. Are you at risk of developing heart disease?
  4. What are your numbers?
  5. Major Risk Factors
  6. Cholesterol and Heart Disease Risk
  7. Ways to Lower Your Cholesterol
  8. Weight and Heart Disease
  9. Diabetes and Heart Disease
  10. What Else Affects Heart Disease
  11. Risk Factors Specific to Women
  12. Taking Charge: An Action Plan for Heart Health
  13. Give Your Heart a Little TLC
  14. Figuring Out Fat
  15. Aim for a Healthy Weight – Part 1
  16. Aim for a Healthy Weight – Part 2
  17. Time to be Active
  18. You Can Quit Smoking
  19. Aspirin – Take with Caution
  20. Heart Healthy is a Family Affair
  21. A Change of Heart