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Diabetic Heart Disease
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Blood Heart Circulation

Diabetic Heart Disease

Diabetic heart disease refers to heart conditions in people with diabetes, who face a significantly higher risk of heart disease and stroke at a younger age.

Understanding Diabetes

Diabetes is a disease characterized by high blood glucose levels. Glucose, derived from food, requires the hormone insulin to enter cells for energy. In type 1 diabetes, the body does not make insulin; in type 2, it does not use it effectively. This leads to a buildup of glucose in the blood.

What is Diabetic Heart Disease?

Over time, high blood sugar damages the nerves and blood vessels in the heart. This increases the risk of:

  • Coronary artery disease (CAD): Plaque buildup in the arteries supplying the heart.
  • Heart failure: The heart cannot pump enough oxygen-rich blood to meet the body's needs.
  • Cardiomyopathy: A group of diseases where the heart muscle becomes thick or stiff.

Risk Factors

Diabetes increases the risk of other conditions that further threaten heart health, such as high blood pressure, high LDL ("bad") cholesterol, and high triglycerides. Other risk factors include:

  • Being male
  • Smoking
  • Obesity
  • Excess belly fat (waist circumference over 40 inches for men or 35 inches for women)
  • Family history of heart disease
  • Chronic kidney disease

Symptoms

Early-stage heart disease often presents no symptoms. As it progresses, symptoms may include:

  • Shortness of breath
  • Fatigue
  • Dizziness or fainting
  • Arrhythmia
  • Swollen feet and ankles
  • Chest pain

Note: People with diabetes may not feel chest pain due to nerve damage caused by the disease. Any potential symptoms should be discussed with a health care provider.

Diagnosis

Providers diagnose diabetic heart disease by reviewing medical history and family history, performing a physical exam, and conducting tests, such as:

  • Blood tests for cholesterol, triglycerides, and blood sugar.
  • Blood-pressure checks.
  • Heart tests, if necessary.

Prevention

You can help prevent or manage heart disease by working with your provider to:

  • Control blood sugar levels.
  • Manage other risk factors.
  • Adhere to prescribed medications.
  • Adopt heart-healthy habits.
  • Follow a diabetes-appropriate eating plan.

Frequently Asked Questions

While individual targets can vary, general goals for heart protection include an A1C level below 7% (or as recommended by your doctor), blood pressure below 130/80 mmHg, and LDL ("bad") cholesterol below 100 mg/dL (or even lower for those with existing heart disease). Triglycerides should ideally be below 150 mg/dL and HDL ("good") cholesterol above 40 mg/dL for men and 50 mg/dL for women.
Regular screening is important for people with diabetes, even without symptoms. This typically includes annual physical exams, blood pressure checks, lipid panel tests, and A1C measurements. Your doctor may also recommend periodic electrocardiograms (ECGs) or other cardiac assessments, especially if you have additional risk factors or have had diabetes for a long time.
Key lifestyle changes include adopting a heart-healthy diet low in saturated and trans fats, cholesterol, and sodium, and rich in fruits, vegetables, whole grains, and lean proteins. Regular physical activity, such as at least 150 minutes of moderate-intensity exercise per week, is crucial. Quitting smoking, limiting alcohol intake, and maintaining a healthy weight are also vital for heart protection.
Due to nerve damage (neuropathy) caused by high blood sugar, people with diabetes may not feel typical chest pain during a heart attack. Instead, they might experience "silent" heart attacks or atypical symptoms such such as unexplained shortness of breath, unusual fatigue, nausea, lightheadedness, sweating, or discomfort in the jaw, neck, back, or arms. Any new or worsening of these symptoms warrants immediate medical attention.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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