Wahida Karmally, Dr.Ph., R.D., associate research scientist and director of nutrition of the Irving Center for Clinical Research in the Columbia University Medical Center in New York, explains:
Even when blood sugar levels are under control, diabetes increases the risk of heart disease and stroke. The risks are even greater if blood sugar is not well controlled. This occurs because diabetes causes damage to the blood vessels and arteries throughout the body including the ones that supply blood to your heart and brain. As this damage occurs, it becomes easier for plaque to form in the arteries. This buildup (atherosclerosis) is what can increase your blood pressure.
When high blood pressure exists with obesity, smoking, high blood cholesterol or diabetes, the risk of heart attack or stroke increases several times. It's very important to control your weight and blood cholesterol with a low-saturated-fat, low-cholesterol, plant-based diet and regular exercise. It's also important to lower high blood pressure and not to smoke.
Diabetes is a coronary heart disease risk equivalent. This means the risk for major coronary events is equal to that in established coronary heart disease. The risk for cardiovascular disease, such as heart attack and stroke, is higher because most people with diabetes have other health problems such as high blood pressure and blood cholesterol.
If you have diabetes, you can reduce your risk for cardiovascular disease and stroke by controlling your
- Blood sugar — Aim for hemoglobin (HbA1c) below 7.
- Blood pressure — Keep it below 130/80 mmHg.
- Blood cholesterol — LDL-cholesterol target is less than 100 mg/dL; triglycerides less than 100 mg/dL; and HDL cholesterol greater than or equal to 40 mg/dL.
Managing your weight, eating a plant-based healthy diet, engaging in regular physical activity and taking medications (if prescribed by your healthcare provider) can also help you reach your treatment goals.