7 Steps to Protect Your Diabetic Heart

Fears about diabetes complications often focus on blindness, kidney disease, amputations -- problems caused by damage to small blood vessels. But there's a larger issue: heart disease. Here are steps you can take to prevent or minimize heart disease (and other diabetes complications, too).

The benefit of changing and treating heart disease risk factors is a healthier, longer life. "Staying healthy with diabetes goes beyond keeping tabs on blood glucose and includes controlling blood pressure and cholesterol," says Chris Tobin, R.N., CDE, president of Health Care and Education for the American Diabetes Association (ADA). "The earlier in the process you can intervene, the fewer problems you're likely to experience."

Start now:

1. Shed a few pounds. Losing just 5-7 percent of your weight (that's 10-14 pounds for a 200-pound person) can decrease the harmful inflammation and insulin resistance that characterize type 2 diabetes. This is especially effective early on, before type 2 diabetes is diagnosed or detected.

2. Eat healthfully and be active -- always. Choosing healthful foods, controlling portions, and being physically active will serve you well your entire life.

3. Reach and maintain your health targets. If you're not meeting the ABC targets (below) for blood glucose, blood pressure, and cholesterol, urge your provider to step up your treatment. "When it comes to prioritizing efforts on lipids to reduce heart disease, research shows targeting LDL (bad) cholesterol is most important," says Robert H. Eckel, M.D., professor of medicine at the University of Colorado Denver and spokesperson for the American Heart Association's Heart of Diabetes campaign. "Triglycerides are of secondary importance, and evidence is still lacking for the benefit of raising HDL (good) cholesterol."

ABC targets* are:

A1C (blood glucose)
A1C: < 7%
Blood glucose:

  • Fasting/before meals: 70-130 mg/dl
  • 1-2 hours after the start of a meal: < 180 mg/dl


Blood pressure
Blood pressure: < 130/80 mmHg

Cholesterol/blood lipids
Total cholesterol: < 200 mg/dl
Triglycerides: < 150 mg/dl
LDL (bad) cholesterol: < 100 mg/dl
  with heart disease: < 70 mg/dl
HDL (good) cholesterol:
  Men > 40 mg/dl
  Women > 50 mg/dl

4. Take your medicine. You may be on a slew of medications to control your ABCs -- no one enjoys that cost or commitment. But research shows that people with diabetes are likely to need more medications over time to manage the progression of diabetes and heart disease. Talk to your provider if you have difficulty taking or affording your medications.

5. Take an aspirin a day. Daily low-dose aspirin (81 mg) therapy is recommended for many people at risk for or with heart disease and diabetes. Ask your provider if daily aspirin is right for you.

6. Don't smoke. If you do smoke, talk to your health care provider about how to quit.

7. Get the health tests you need. Your provider can refer to the ADA Standards of Medical Care, which outline research-based guidelines for detecting problems and managing the ABCs. The goal is to spot problems early and initiate treatment quickly.

Bring this to your next doctor appointment:
Checkup Checklist

Hope Warshaw, R.D., CDE, a contributing editor for Diabetic Living, is the author of several American Diabetes Association books, including Real-Life Guide to Diabetes (2009).

*From American Diabetes Association 2010 Clinical Practice Recommendations. If you have had diabetes for a long time, have other health problems, or have frequent low blood sugar, your A1C target may need to be higher than 7 percent. Discuss with your health care provider.