Heart disease is a major issue in the United States, responsible for every one in four deaths. It is the leading cause of death for both men and women, according to the Center for Disease Control. While that may seem like a bleak statistic, new research is constantly being done to better understand heart disease and how it can be treated.

A key part of preventing heart disease is knowing the risk factors. Some of these risk factors include obesity, high blood pressure, high cholesterol, smoking, and family history.

Diabetes is also a large risk factor for heart disease. However, it is controllable. The American Heart Association views diabetes as one of the seven major controllable risk factors for cardiovascular disease.

Diabetes

The issue is patients with diabetes have a much higher risk of cardiovascular disease than a patient without diabetes,” explained Dr. Enrico Cagliero, Associate Physician at Massachusetts General Hospital. “It’s about a two-fold increase in risk.”

According to the American Heart Association, adults with diabetes are two to four times more likely to die from heart disease than other patients. In addition, 68 percent of diabetic patients over the age of 65 die from some form of heart disease.

“Patients with diabetes have double to triple the risk of heart attack, stroke, and heart failure.” said Dr. Cagliero, explaining what type of issues patients with diabetes face.

Patients with diabetes often have other health issues that are associated with cardiovascular disease, such as high blood pressure, high triglyceride and cholesterol levels, and obesity.

While these statistics may seem negative, diabetic patients should not lose hope. There are many things that patients can do to improve their chances at staying heart-healthy.

New Strategies for Heart Disease in Diabetic Patients

Several new theories and treatment strategies surrounding the issue of cardiovascular disease in diabetic patients have been developed recently.

One avenue of hope for diabetic patients is glucose level control. Research is suggesting that newly diagnosed patients can lower their risk of cardiovascular disease by closely monitoring their glucose levels.

“If you are newly diagnosed with diabetes, tight glucose control is really the key because it prevents complications from diabetes and eventually will also help reduce the risk of heart disease,” explained Dr. Cagliero. “If you take someone newly diagnosed with diabetes and you keep very good glucose control, you can eventually prevent heart disease, but it takes a very long time. The studies have shown an improvement after at least ten years.”

Patients that are already living with diabetes won’t benefit from controlled glucose levels the way that newly diagnosed patients can, but new medications are being developed that can help.

Researchers are looking at new cardiovascular medications, specifically designed for patients with diabetes and heart disease.

“For people that already have the diagnosis of diabetes and people that already have heart disease, now there are specific drugs that help with blood sugar, and they also help reduce the risk of another heart attack or stroke or cardiovascular morbidity,” Dr. Cagliero surmised.

“Over the last few years, because there were reports of medications with diabetes potentially being bad for the heart, the FDA has mandated that every new drug is studied for cardiovascular safety,” said Dr. Cagliero, explaining how these drugs were discovered. “There have now been 3 or 4 drugs that have shown that they can help in reducing the risk of heart disease independent of glucose control.”

“We are very excited in the field of diabetes that we now have drugs that are good for reducing the risk of heart attacks, strokes, or in some studies just total death,” he continued. 

Some medications that have been shown to help patients with diabetes and heart disease include empagliflozin, canagliflozin, and liraglutide.

Moving Forward with Diabetes

Diabetes is a difficult disease that requires time and effort to manage. For some patients, it can be a daunting task, but it’s worth it in the end. Making the right choices now can give patients a brighter future.

“Diabetes is a disease that is really kind of tough, because it’s not just taking a pill, but involves lifestyle changes: diet, exercise, and frequently monitoring blood sugar levels. Sometimes patients get exhausted by doing that and they don’t see any major improvements,” Dr. Cagliero acknowledged, while discussing the importance of managing the disease.

“If you stick with these preventive measures, because diabetes is a lifelong disease, you are going to be better off. You could be better off, not now, but 5 or 10 years down the road. Having to do a lot of work to see no significant improvement in your sense of well-being is tough. But, you have to put that into perspective. If you do the work now, you can avoid having a heart attack down the road, developing kidney disease, and all these other preventable issues that are troublesome or are very severe.”