Prevent Diabetes Problems: Keep Your Heart and Blood Vessels Healthy

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What are diabetes problems?

High blood glucose can cause heart and blood vessel problems.

Too much glucose (sugar) in the blood for a long time can cause diabetes problems. This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes, the leading causes of death for people with diabetes. You can do a lot to prevent or slow down diabetes problems.

This booklet is about heart and blood vessel problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.

What should I do each day to stay healthy with diabetes?

	Follow the healthy eating plan that you and your doctor or dietitian have worked out.
	Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
	Take your diabetes medicines at the same times each day.
	Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book.
	Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
	Brush and floss your teeth and gums every day.
	Don't smoke.

What do my heart and blood vessels do?

Your heart and blood vessels make up your circulatory (SIR-kyoo-la-TOR-ee) system. Your heart is a big muscle that pumps blood through your body. Your heart pumps blood carrying oxygen to large blood vessels, called arteries (AR-ter-eez), and small blood vessels, called capillaries (KAP-ih-lair-eez). Other blood vessels, called veins, carry blood back to the heart.

What can I do to prevent heart disease and stroke?

• Keep your blood glucose under control. You can see if it is under control by having an A1C test at least twice a year. The A1C test tells you your average blood glucose for the past 2 to 3 months. The target for most people is below 7.
  
  
• Keep your blood pressure under control. Have it checked at every doctor visit. The target for most people is below 130/80.
  
  
• Keep your cholesterol under control. Have it checked at least once a year. The targets for most people are
  
  
  • LDL (bad) cholesterol: below 100
  
  
  
  • HDL (good) cholesterol: above 40 in men and above 50 in women
  
  
  
  • Triglycerides (another type of fat in the blood): below 150
  
  
  

Choose an activity you like and stay active.

• Make physical activity a part of your daily routine. Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you. Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the lot.
  
  
• Make sure that the foods you eat are "heart-healthy." Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits, and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil.
  
  
• Lose weight if you need to. If you are overweight, try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.
  
  
• If you smoke, quit. Your doctor can tell you about ways to help you quit smoking.
  
  
• Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
  
  
• Take your medicines as directed.

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How do my blood vessels get clogged?

Several things, including having diabetes, can make your blood cholesterol level too high. Cholesterol is a substance that is made by the body and used for many important functions. It is also found in some food derived from animals. When cholesterol is too high, the insides of large blood vessels become narrowed, even clogged. This problem is called atherosclerosis (ATH-uh-row-skluh-RO-sis).

Narrowed and clogged blood vessels make it harder for enough blood to get to all parts of your body. This can cause problems.

Healthy Blood Vessel

Narrowed Blood Vessel

What can happen when blood vessels are clogged?

When arteries become narrowed and clogged, you may have heart problems:

• Chest pain, also called angina (an-JY-nuh). When you have angina, you feel pain in your chest, arms, shoulders, or back. You may feel the pain more when your heart beats faster, such as when you exercise. The pain may go away when you rest. You also may feel very weak and sweaty. If you do not get treatment, chest pain may happen more often. If diabetes has damaged the heart nerves, you may not feel the chest pain.
  
  
• Heart attack. A heart attack happens when a blood vessel in or near the heart becomes blocked. Not enough blood can get to that part of the heart muscle. That area of the heart muscle stops working, so the heart is weaker. During a heart attack, you may have chest pain along with nausea, indigestion, extreme weakness, and sweating.

What are the warning signs of a heart attack?

You may have one or more of the following warning signs:

• chest pain or discomfort
• pain or discomfort in your arms, back, jaw, or neck
• indigestion or stomach pain
• shortness of breath
• sweating
• nausea or vomiting
• light-headedness

Or, you may have no warning signs at all. Or they may come and go.

How does heart disease cause high blood pressure?

Narrowed blood vessels leave a smaller opening for blood to flow through. It is like turning on a garden hose and holding your thumb over the opening. The smaller opening makes the water shoot out with more pressure. In the same way, narrowed blood vessels lead to high blood pressure. Other factors, such as kidney problems and being overweight, also can lead to high blood pressure.

Many people with diabetes also have high blood pressure. If you have heart, eye, or kidney problems from diabetes, high blood pressure can make them worse.

High Pressure

Low Pressure

You will see your blood pressure written with two numbers separated by a slash. For example: 120/70. Keep your first number below 130 and your second number below 80.

If you have high blood pressure, ask your doctor how to lower it. Your doctor may ask you to take blood pressure medicine every day. Some types of blood pressure medicine can also help keep your kidneys healthy.

To lower your blood pressure, your doctor may also ask you to lose weight; eat more fruits and vegetables; eat less salt and high-sodium foods such as canned soups, luncheon meats, salty snack foods, and fast foods; and drink less alcohol.

To lower blood pressure, get to a healthy weight.

What are the warning signs of a stroke?

A stroke happens when part of your brain is not getting enough blood and stops working. Depending on the part of the brain that is damaged, a stroke can cause

• sudden weakness or numbness of your face, arm, or leg on one side of your body
  
  
• sudden confusion, trouble talking, or trouble understanding
  
  
• sudden dizziness, loss of balance, or trouble walking
  
  
• sudden trouble seeing in one or both eyes or sudden double vision
  
  
• sudden severe headache
  

Sometimes, one or more of these warning signs may happen and then disappear. You might be having a "mini-stroke," also called a TIA (transient ischemic [TRAN-see-unt is-KEE-mik] attack). If you have any of these warning signs, tell your doctor right away.

How can clogged blood vessels hurt my legs and feet?

Peripheral vascular (puh-RIF-uh-rul VAS-kyoo-ler) disease can happen when the openings in your blood vessels become narrow and not enough blood gets to your legs and feet. You may feel pain in your buttocks, the back of your legs, or your thighs when you stand, walk, or exercise.

What can I do to prevent or control peripheral vascular disease?

• Don't smoke.
• Keep blood pressure under control.
• Keep blood fats close to normal.
• Exercise.

You also may need surgery to treat this problem.

For More Information

Diabetes Teachers (nurses, dietitians, pharmacists, and other health professionals)

To find a diabetes teacher near you, call the American Association of Diabetes Educators toll-free at 1-800-TEAMUP4 (1-800-832-6874), or look on the Internet at www.diabeteseducator.org and click on "Find a Diabetes Educator."

Dietitians

To find a dietitian near you, call the American Dietetic Association toll-free at 1-800-366-1655, or look on the Internet at www.eatright.org and click on "Find a Nutrition Professional."

Government

The National Heart, Lung, and Blood Institute (NHLBI) is part of the National Institutes of Health. To learn more about heart and blood vessel problems, write or call NHLBI Information Center, P.O. Box 30105, Bethesda, MD 20824-0105, (301) 592-8573; or see www.nhlbi.nih.gov on the Internet.

To get more information about taking care of diabetes, contact

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: 1-800-860-8747 or (301) 654-3327
Fax: (301) 907-8906
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892-3600
Phone: 1-800-438-5383
Fax: (301) 907-8906
Internet: http://ndep.nih.gov

American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1-800-342-2383
Internet: www.diabetes.org

Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005-4001
Phone: 1-800-533-2873
Internet: www.jdrf.org

More in the Series

The "Prevent Diabetes Problems" series has seven booklets that can help you learn more about how to prevent diabetes problems.

• Keep Your Diabetes Under Control
• Keep Your Eyes Healthy
• Keep Your Feet and Skin Healthy
• Keep Your Heart and Blood Vessels Healthy
• Keep Your Kidneys Healthy
• Keep Your Nervous System Healthy
• Keep Your Teeth and Gums Healthy

For free single copies of these booklets, write, call, fax, or email the

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560

Phone: 1-800-860-8747 or (301) 654-3327
Fax: (301) 907-8906
Email: ndic@info.niddk.nih.gov

These booklets are also available at www.diabetes.niddk.nih.gov on the Internet.

Acknowledgments

The National Diabetes Information Clearinghouse thanks the people who helped review or field-test this publication.

National Diabetes Information Clearinghouse

1 Information Way
Bethesda, MD 20892-3560
Email: ndic@info.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1978, the clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.

NIH Publication No. 03-4283
September 2003