Diabetes and cardiovascular disease

When you have diabetes, it's easy to focus solely on the highs and lows of your blood sugar levels. But besides your blood sugar, you need to pay close attention to what is happening to your heart and blood vessels.

That is because cardiovascular disease is the most common and most serious complication of diabetes, increasing your risk of heart attack and stroke. In fact, about 65 percent of people with diabetes die of these two conditions.

The statistics may sound alarming, but you are not destined to face cardiovascular disease or stroke. With the help of your doctor, you can take key actions to help lower your risk.

Manage your blood sugar

Keeping your blood sugar levels within optimal ranges can prevent or delay blood vessel damage. The best way to assess your blood sugar level over time is the hemoglobin A1C test. It reflects your average blood sugar control over the last three months.Your goal: A hemoglobin A1C level of less than seven. If yours is seven or higher, your doctor will need to adjust your diabetes treatment.

Keep your blood sugar in check

High blood pressure (hypertension) can lead to a variety of cardiovascular complications for anyone, not just people with diabetes. But when you have diabetes, it can increase the severity of those complications and hasten their development. And about 73 percent of adults with diabetes have high blood pressure.

Your goal: A blood pressure lower than 140/90 millimeters of mercury. If your blood pressure is higher, your doctor will likely prescribe medication to bring it down.

Keep blood vessels open by controlling cholesterol and triglycerides

Unhealthy levels of blood fats — cholesterol and triglycerides — can also cause cardiovascular disease in anyone, with diabetes or without. But like high blood pressure, the damage is usually worse and more rapid when you have diabetes.

People with diabetes most commonly have elevated triglycerides and a decreased level of high-density lipoprotein (HDL) cholesterol — the "good" cholesterol. In addition, in people with diabetes, particles of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — are usually smaller and denser, making them more likely to block blood vessels.

Your targets: LDL below 100 — perhaps as low as 70 if you have other heart disease risk factors and take cholesterol-lowering medication; HDL above 50 for women and above 40 for men; triglycerides below 150.

Understanding the strong link between diabetes and cardiovascular disease is an important step in preventing life-threatening complications. So talk to your doctor about your risk factors and how you can change them, and about getting periodic assessments to see if you're meeting your goals.