The 6 Biggest Heart Disease Risks for People With Type 2 Diabetes

1. High A1C

How to Lower Your A1C

If you have access to a continuous glucose monitor, use this wearable tool — even temporarily — to see how your blood sugar responds to the foods and meals you’re eating, says Schrager. With that information in hand, you can make adjustments to the foods or combinations of foods you eat to promote a better-balanced blood sugar response.

2. Kidney Damage

One of the long-term health complications of diabetes is damage to the circulatory system, including the tiny blood vessels in the kidneys, negatively impacting their ability to filter waste, says Melissa Joy Dobbins, RDN, CDCES, a Chicago-area diabetes educator.

Preventing Kidney Damage

3. High Blood Pressure

Controlling Your Blood Pressure

“Managing your blood pressure is done through diet, exercise, weight management, and medication,” says Dobbins.

Meanwhile, potassium, an essential mineral abundant in fruits and vegetables, can help counterbalance sodium. “Sometimes the problem is not getting enough potassium,” says Dobbins. “That’s one reason why we recommend eating fruits and vegetables.”

“Start small with a 10-minute walk daily,” says Schrager.

4. Smoking

The Benefits of Quitting

Smoking less is always a benefit to your health, but the ultimate goal for heart health is to quit smoking altogether.

5. High Cholesterol

Improving Your Cholesterol

Many healthy habits can help improve your cholesterol numbers. Schrager recommends focusing on eating high-fiber foods. “Fiber helps lower [“bad’] LDL cholesterol by binding to cholesterol and carrying it out of the body,” she says.

To increase the amount of fiber in your diet, Schrager suggests:

• Add fresh or frozen fruits or vegetables to each meal.
• Choose whole grains like brown rice, quinoa, or farro over refined grains like white rice and pastas.
• Integrate beans and lentils into soups, stews, salads, and more.
• Sprinkle seeds like chia, ground flax, or hemp onto oatmeal or yogurt.

6. Excess Weight

In short, excess fat is a risk for both heart health and diabetes progression.

The Many Benefits of Weight Loss

“Losing weight creates a cascade effect, making blood sugar easier to manage and reducing blood pressure,” says Dobbins. What’s more, weight loss can make it easier to exercise, which can help you feel better and get better sleep, says Schrager.

Weight loss can also include visceral fat loss, which will further benefit your heart, says Schrager.

A registered dietitian, particularly one who works with people who have diabetes, can help you put an effective eating, exercise, and lifestyle plan in place to support your weight loss goals. In some instances, glucagon-like peptide-1 (GLP-1) receptor agonist medications like semaglutide or tirzepatide may be an option for you, says Dobbins. “They have been a game changer for many people,” she says.

The Takeaway

• If you have diabetes, keeping your A1C on target is one of the best possible ways to minimize your heart health risks. Good blood sugar management can reduce the direct damage that diabetes causes to the cardiovascular system.
• Blood sugar, blood pressure, and cholesterol are all very closely related. The right medications and healthy diet and exercise habits can help improve your metabolic health comprehensively, lowering both heart health and diabetes risks simultaneously.
• Further protect your heart health by quitting smoking and aiming for modest weight loss of 5–10 percent of your body weight, which can make both blood sugar and blood pressure much easier to manage.