By Dr. Ashwin Karuppan
Why Diabetes and Heart Disease Are Linked
When blood sugar stays high for a long time, it slowly damages the inner walls of blood vessels. This damage makes it easier for fatty deposits (plaque) to build up inside arteries, including the ones that supply blood to the heart. Over time, this narrows the arteries and can lead to a heart attack.
People with diabetes are two to four times more likely to develop heart disease than those without it. What makes this especially dangerous is that many people with diabetes don’t feel the usual warning signs of a heart problem — a condition called “silent ischemia.” Nerve damage from long-term high blood sugar can cause dull chest pain, so a heart attack may arrive without the classic warning signs.
Who Is at Higher Risk
The risk climbs further if you also have:
- High blood pressure
- High cholesterol, especially high triglycerides and low “good” (HDL) cholesterol
- Excess weight, particularly around the abdomen
- A family history of heart disease
- A habit of smoking
- Poorly controlled blood sugar over many years
If several of these apply to you, it’s worth having a frank conversation with your doctor about your heart risk — not just your sugar levels.
Warning Signs Not to Ignore
Because symptoms can be milder or different in people with diabetes, don’t wait for classic “movie style” chest-clutching pain. Pay attention to:
- Unusual tiredness or breathlessness during normal activity
- Discomfort in the chest, jaw, neck, back, or arms
- Sudden sweating, nausea, or dizziness without clear cause
- Swelling in the legs or ankles
If any of these appear suddenly, seek medical help immediately rather than waiting it out.
Practical Steps the Public Can Adopt
The encouraging news is that this risk is largely manageable with everyday habits:
- Know your numbers. Get your blood sugar (HbA1c), blood pressure, and cholesterol checked regularly — not just once a year, but as often as your doctor recommends. Awareness is the first line of defense.
- Move daily, not occasionally. Aim for at least 30 minutes of brisk walking most days. Regular movement helps control blood sugar, weight, and blood pressure all at once.
- Rethink your plate. Reduce refined carbohydrates (white rice, maida, sugary drinks) and favor whole grains, vegetables, and lean protein. Portion control matters as much as food choice.
- Don’t skip your medications. Whether it’s for sugar, blood pressure, or cholesterol, consistent use — not occasional use — is what protects your heart over years.
- Quit smoking and limit alcohol. Both directly damage blood vessels and multiply heart risk in people with diabetes.
- Manage stress and sleep. Poor sleep and chronic stress raise blood sugar and blood pressure, quietly working against your heart health.
- Don’t normalize being “a little unwell.” Persistent fatigue or breathlessness is not just “getting older” get it checked.
The Takeaway
Diabetes and heart disease are closely connected, but this connection is not a life sentence. With regular check-ups, consistent medication, and a few sustainable lifestyle changes, people with diabetes can significantly lower their heart attack risk and lead long, active lives. The key is not to wait for symptoms — prevention starts with the choices made today.
Dr Ashwin Karuppan is the Founder & Chairman of C.O.D.E Clinic, Chennai