Opinion: Understanding The Risk Of Heart Disease With Diabetes

According to a report by the Public Health Foundation of India, 25% of people with diabetes in India have a high risk of cardiovascular illnesses. 

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Dr Tiny Nair

Diabetes and heart disease are two prevalent health conditions that are frequently comorbid. For those living with diabetes, understanding the risk of heart disease is essential, as research shows a significantly higher likelihood of cardiovascular issues among people with diabetes than in the general population.

The effects of high blood sugar on blood vessels and neurons are a major factor in the association between diabetes and heart disease. Elevated blood glucose levels over time can lead to atherosclerosis, a disorder that narrows and stiffens the arteries, limiting blood flow to the heart. 

According to a report by the Public Health Foundation of India, 25% of people with diabetes in India have a high risk of cardiovascular illnesses. Heart disease is currently one of the major causes of death in India, according to The Global Burden of Disease Study 2024. This emphasises how important it is for people with diabetes to be conscious of their heart health. 

The risk of heart disease is increased by several other diabetes-related risk factors. Adults with diabetes frequently also have high blood pressure, which raises their risk of heart attacks and strokes, according to the Centers for Disease Control and Prevention (CDC). These risks are further increased by obesity, a common co-condition with type 2 diabetes that is linked to decreased blood flow and raised cholesterol.

Lifestyle changes and early intervention are among the most effective strategies to reduce these risks. According to a report published in the National Library of Medicine, well-controlled blood glucose, blood pressure, and cholesterol is associated with a lower risk of cardiovascular complications. Exercise is a particularly effective tool, as it improves heart function, reduces inflammation, and enhances insulin sensitivity. Even moderate activities such as walking can make a difference. Alongside exercise, adopting a balanced diet — low in sugar, unhealthy fats, and refined carbs — helps control blood sugar and cholesterol, further protecting the heart.

Frequent monitoring is also very important. The American Heart Association (AHA) advises people with diabetes to monitor their blood sugar, cholesterol, and blood pressure. Regular screenings with medical professionals can help identify problems early and avoid complications.

While diabetes increases the risk of heart disease, adopting the right lifestyle changes and preventative healthcare can greatly reduce this risk. Some innovative diabetes drugs, like SGLT2 inhibitors and GLP-1 receptor agonists, have been proven effective not only for managing blood sugar but also for improving heart and kidney health. These medications, which have undergone rigorous cardiovascular safety testing, are now considered a standard of care for patients with Type 2 Diabetes and associated cardiovascular risks.

The writer, MD, DM, FACC, FRCP, is Head-Dept of Cardiology at PRS Hospital, Trivandrum.

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