How Type 2 Diabetes Increases Your Risk for Heart Attack and Stroke

How Type 2 Diabetes Increases Your Risk for Heart Attack and Stroke

There are steps you can take to lower your risk.

The facts around diabetes, heart disease and stroke are worrisome: Compared to people without diabetes, those with the disease are nearly two times as likely to die from heart disease or stroke. But there is some good news. Although type 2 diabetes is considered a major risk factor for heart disease, it is also considered a “controllable risk factor.” This means you have the ability to reduce your risk of heart disease, heart attack and stroke by taking steps to properly manage diabetes and keep the condition under control.

How type 2 diabetes contributes to heart attack and stroke
The high blood sugar levels associated with type 2 diabetes can cause major damage to the blood vessels. They can also contribute to high blood pressure and unhealthy cholesterol levels.

Type 2 diabetes increases the risk of blood clots in the heart and brain, as well, which trigger the majority of heart attacks and strokes.

The cause of blood clotting in people with type 2 diabetes is atherosclerosis, or a buildup of plaque—waxy substances in the blood made up of cholesterol, fat and cellular waste products—inside the arteries. When this plaque accumulates in the arteries that supply the heart with blood, it is called coronary artery disease—a term that is often used interchangeably with heart disease. When the buildup occurs in the arteries of the limbs, it is called peripheral artery disease. If the plaque buildup ruptures, a blood clot can form, blocking blood flow.

A heart attack, also called a myocardial infarction, occurs when one or more of the arteries that supply the heart with oxygen-rich blood becomes blocked or severely narrowed. Deprived of this oxygen-rich blood, the heart muscle begins to die.

Strokes are sometimes called “brain attacks,” and occur when there is an interruption in the supply of oxygen and blood to the brain. When a stroke occurs, brain tissue begins to die within minutes, which is why timely treatment is essential for preventing serious and permanent damage.

There are several varieties of stroke. The most common type is ischemic, which occurs when a blood vessel is blocked, usually by a blood clot. Hemorrhagic strokes occur when a blood vessel in the brain ruptures. There is a third type of stroke known as a transient ischemic attack (TIA), or mini-stroke. A TIA occurs when there is a temporary blockage of a blood vessel that lasts only a few minutes. TIAs are sometimes called “warning strokes” because they are often followed by a stroke with permanent damage.

What you can do to reduce your risk
Keeping type 2 diabetes under control will help you reduce your risk of heart disease, heart attack, stroke and other potentially fatal heart-related events. A lifestyle built around a healthy diet, regular physical activity and avoiding harmful habits is essential:

  • Eat a balanced diet that includes plenty of vegetables, fruits, whole grains and lean protein, and consider seeing a dietitian or nutritionist if you need help developing an eating plan that works for you.
  • If you’re overweight or obese, work towards achieving a healthy weight.
  • Avoid foods that contain high levels of sugar, sodium, unhealthy fats and cholesterol. It’s also important to limit your alcohol intake or avoid it entirely.
  • Move more. Most adults should exercise for at least 30 minutes a day, five days a week. Check with your healthcare provider about the right level of exercise for you.
  • Do not smoke, and quit if you do. Smoking significantly increases your risk of type-2 diabetes complications.

Additionally, follow the blood sugar monitoring schedule and treatment plan prescribed by your healthcare provider. Have your ABC numbers (A1C, blood pressure, cholesterol) checked regularly. Some people with type 2 diabetes may also see a cardiologist to more closely monitor their heart health, and some take medications to protect their heart and brain.

Medically reviewed in November 2019.

National Institute of Diabetes and Digestive and Kidney Diseases. “Diabetes, Heart Disease, and Stroke.”
American Heart Association. “Cardiovascular Disease and Diabetes,” “Understand Your Risk for Excessive Blood Clotting,” “About Heart Attacks.”
American Stroke Association. “About Stroke.”
National Heart, Lung, and Blood Institute. “Coronary Heart Disease: Causes,” “Atherolsclerosis.”
JM Lee, MC Grabb, et al. “Brain tissue responses to ischemia.” The Journal of Clinical Investigation. Vol. 106,6 (2000): 723-31.
MedicalNewsToday. “What is a transient ischemic attack (TIA)?”
Centers for Disease Control and Prevention. “Smoking and Diabetes."

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