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.
What is your biggest daily challenge living with type 1 diabetes?
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.
Resources We Trust
- Mayo Clinic: Strategies to Prevent Heart Disease
- American Heart Association: Cardiovascular Disease and Diabetes
- Johns Hopkins Medicine: Diabetes and Heart Health
- Centers for Disease Control and Prevention: Diabetes and Your Heart
- Harvard Health Publishing: Shining a Light on the Diabetes-Heart Disease Connection
- Heart and Kidney Diseases and Type 2 Diabetes May Be One Ailment. Scientific American. December 16, 2025.
- What Is the A1C Test? American Diabetes Association.
- Diabetes and Your Heart. Centers for Disease Control and Prevention. May 15, 2024.
- Martinez M et al. Glycemic Variability and Cardiovascular Disease in Patients With Type 2 Diabetes. BMJ Open Diabetes Research and Care. March 24, 2021.
- Life’s Essential 8 - How to Manage Blood Sugar Fact Sheet. American Heart Association.
- Chronic Kidney Disease. Centers for Disease Control and Prevention. May 15, 2024.
- Chronic Kidney Disease. National Kidney Foundation. September 11, 2023.
- Diabetes and Kidney Disease (Stages 1-4). National Kidney Foundation.
- High Blood Pressure—Understanding the Silent Killer. U.S. Food and Drug Administration. April 11, 2024.
- Health Threats from High Blood Pressure. American Heart Association. August 14, 2025.
- Diabetes and Hypertension: A Dangerous Duo. NewYork-Presbyterian.
- Exercise: A Drug-Free Approach to Lowering High Blood Pressure. Mayo Clinic. December 14, 2024.

Chung Yoon, MD
Medical Reviewer

Jessica Migala
Author
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabet...