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Is heart disease inevitable among people with diabetes?

No. The best way to prevent or delay the development of significant cardiovascular disease is to prevent diabetes itself.

What are the best ways to prevent diabetes?

Weight Reduction and Exercise

Modest weight reduction and 30 minutes of exercise five days per week can reduce the development of type 2 diabetes over three years by 50 percent.

Blood Glucose, Blood Pressure and Cholesterol Control

But even those with diabetes can treat abnormalities in blood pressure and cholesterol levels in order to prevent cardiovascular disease. Controlling blood glucose levels is of paramount importance for preventing many complications of diabetes, probably including the risk of heart disease.

What are the goals?

  • Blood Glucose: Blood glucose levels are measured at home to provide information regarding daily diabetic control and to guide the health care provider with medication adjustment. Generally, glucose levels should range from 80 to 120 mg/dl prior to meals; however these values may vary among individual patients. The best way to measure blood glucose levels over time is by the so-called A1C test. This blood test reflects average blood glucose levels over three months. The goal is to maintain an average level of less than 7 percent. The test should be given twice a year once adequate control is achieved. The combination of these two blood glucose measurement methods provides the most accurate information to reduce the long term complications of diabetes.
  • Blood Pressure: For people with diabetes, the goal is a blood pressure reading of less than 130/80 mmHg.
  • Cholesterol: The target is less than 100 milligrams per deciliter of blood (mg/dL) for LDL or "bad" cholesterol for people with diabetes. For those who already have heart disease or are at higher risk, the goal is less than 70 mg/dL.

How can these goals be met?

Your doctor can help you devise a plan to meet these guidelines. It will likely include:

  • A healthy diet
  • Regular physical activity
  • Weight loss
  • Quitting smoking
  • Use of one or more blood pressure or cholesterol medications.
    • Research shows that most adults with high blood pressure and diabetes need multiple medications to reach their blood pressure goals, for example.

Is it easy to achieve these goals?

Less than 30 percent of people with diabetes are achieving the recommended blood pressure and cholesterol goals and fewer than 50 percent are meeting the A1C goal of 7. It is important to work with your physician to set up a program aimed at meeting these goals.

Contact Information

Heart Care for Diabetic Patients
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215