When someone has diabetes, checking their blood sugar is a priority. But, they also need to pay close attention to what may be happening to their heart and blood vessels as a result of the diabetes. Diabetes can damage blood vessels, including the arteries that supply blood to the brain and heart.

People with diabetes have a higher-than-average risk of having a heart attack or stroke. The good news is the risk can be reduced by managing blood sugar and blood pressure, controlling cholesterol and making healthy lifestyle changes through diet, exercise and medications.

For people who don’t have diabetes, heart disease speaks loud and clear - inadequate blood flow to the heart causes chest pain or pressure, a pounding heartbeat, shortness of breath, jaw or arm pain, and sweating. People with these signs and symptoms know something’s wrong and are likely to seek help.

However, for those with diabetes, the symptoms of heart disease may not be as noticeable, so they may not seek medical care until more serious complications have occurred. In other words, many diabetics experience a “silent” heart attack and may not know it.

For diabetics, keeping their ABCs in check can help lower the risk for heart disease and stroke. The ABCs are an easy way to remember some of the most important health issues related to diabetes:

- A is for A1C: Reflects the average blood glucose level for the two to three month period before the test. Less than 7 percent is desirable, which corresponds to an average blood glucose level of 150 mg/dL. Physicians monitor A1C results over time, as it helps guide treatment decisions.

- B is for blood pressure: Aim for a blood pressure level below 130/80 mm Hg. If a person’s blood pressure is higher, their physician will likely prescribe a medication to bring it down. They may be asked to monitor their blood pressure at home so the results can be reviewed at the next appointment.

- C is for cholesterol (lipids): A complete cholesterol test, referred to as a lipid panel or lipid profile, includes the measurement of four types of fats (lipids) in the blood:

1. Low-density lipoprotein (LDL): LDL is referred to as the “bad” cholesterol. Too much of it in the blood causes the accumulation of fatty deposits (plaques) in the arteries (atherosclerosis), which reduces blood flow.

2. High-density lipoprotein (HDL): HDL is referred to as the “good” cholesterol because it helps remove LDL cholesterol, keeping arteries open and blood flowing more freely.

3. Total cholesterol: Total cholesterol is the sum of the blood’s cholesterol content.

4. Triglycerides: Triglycerides are another type of fat in the blood. When you eat, the body converts any calories it doesn’t need to use right away into triglycerides, which are stored in fat cells and released later for energy.

Blood sugar, blood pressure and cholesterol aren’t the only things that can lead to cardiovascular disease. Lifestyle choices like poor eating habits, inactivity, smoking, stress and alcohol also can add to the risk. Understanding the strong link between diabetes and cardiovascular disease is an important step in preventing life-threatening complications. Talk to your healthcare team about your risk factors, how you can change them and about periodic assessments, which will help determine if you’re meeting your goals.

Penny Fischer, R.N., is a certified diabetes educator at Flagstaff Medical Center. Is there a health topic you’d like to know more about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N. Beaver St., Flagstaff, AZ 86001, or visit FMC’s website at FlagstaffMedicalCenter.com.

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