Treatment
If you develop cardiovascular disease, the preventive measures listed above can still help you. Even if you are being treated for cardiovascular disease, taking preventive steps can slow or stop the progression of the disease. A low-cholesterol, low-fat diet that is rich in fiber can further lower your levels of cholesterol (the blood vessel–clogging culprits).

But sometimes, prevention alone isn’t enough, especially if you have had cardiovascular disease for a while. You may need medication to reduce blood clotting, to lower cholesterol levels, or to reduce high blood pressure.  If your blood vessels are already blocked or significantly narrowed, you may need surgery to remove the blockage. Angina can also be treated by both preventive and surgical steps. The goal is to increase the amount of oxygen going to the heart.

Several different surgical procedures are now commonly used to remove the blockages of blood vessels. Balloon angioplasty, while not performed as often as it used to be in people with diabetes, is a procedure that uses a balloon at the tip of a long tube. A cardiologist inserts the tube into the blocked artery and then inflates the balloon. This opens up the blocked vessel.

A metal stent, or ring, may be left in place to help the blood vessel stay open. Atherectomy is another kind of minor surgery used to open blood vessels. With this technique, the cardiologist bores a hole through a blocked blood vessel. Laser surgery can also be used to melt away blockages with an intense beam of light. All of these surgeries can remove smaller blockages and require little recovery time.

A more severe blockage calls for more serious surgery.

Cardiac surgeons can create a detour around the blocked artery through arterial bypass surgery.  Maybe you already know someone who has had a single, double, triple, or even quadruple bypass surgery of the heart. Surgeons can construct one, two, three, four, or even more detours, if there are multiple blockages. To do this, surgeons remove a part of a larger artery from the chest wall or from a vein in the patient’s leg and attach it above and below the blocked blood vessel. Now, instead of running up against a wall, blood can flow around the blockage and through the new blood vessel.

Intermittent claudication, or leg pain, is not a nerve problem but a sign of a circulatory problem. It can be relieved by exercise, quitting smoking, drug therapy, and surgery similar to that for blocked heart arteries. Strokes are usually treated by a combination approach. Treatment to lower blood glucose and lipid levels and blood pressure,  therapy to help the person recover mental and physical abilities,  and medications that reduce blood clotting are all effective common approaches.
Sometimes surgery is needed.

People with cardiovascular disease are advised to be physically active and to eat foods that protect the heart and blood ves sels. Because of diabetes, you’ll also need to manage your blood glucose levels and perhaps lose weight as part of your recovery.

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Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association

American Diabetes Association Complete Guide to Diabetes