What Is the Connection Between Diabetes and Heart Disease?

Diabetes and cardiovascular disease are closely linked. Diabetes itself increases cardiovascular risk, while conditions that commonly occur with diabetes—such as high blood pressure, abnormal cholesterol and excess weight—can add to that risk. The American Diabetes Association's 2026 Standards of Care specifically addresses cardiovascular risk management as part of diabetes care.

This does not mean that every person with diabetes will develop heart disease. It means that cardiovascular risk should be assessed and managed as part of routine diabetes care.

1. Keep Blood Sugar Under Individualized Control

Blood glucose management is an important part of diabetes care, but the appropriate target is not identical for everyone. Your clinician may consider your age, diabetes type, medicines, duration of diabetes, hypoglycemia risk, other conditions and personal circumstances when setting goals.

• Monitor glucose using the method recommended for you.
• Take diabetes medicines as prescribed.
• Understand how meals, activity, illness and medicines affect your readings.
• Discuss repeated high or low readings rather than changing medicines on your own.

2. Manage Blood Pressure

High blood pressure is a major cardiovascular risk factor in people with diabetes. The 2026 ADA Standards recommend routine blood-pressure assessment and individualized treatment goals. For people with diabetes and hypertension, an on-treatment goal below 130/80 mmHg may be appropriate when it can be safely achieved, but targets should be individualized.

• Have your blood pressure checked regularly.
• If advised, use a validated home blood-pressure monitor and keep a record.
• Follow your prescribed blood-pressure treatment.
• Discuss dizziness, fainting or unusually low readings with your clinician.

3. Pay Attention to Cholesterol

Diabetes is associated with a higher likelihood of unhealthy cholesterol levels. LDL cholesterol, HDL cholesterol and triglycerides are considered together when assessing lipid health. The 2026 ADA recommendations include lipid testing and appropriate lipid-lowering therapy according to age, cardiovascular risk and clinical circumstances.

Do not start, stop or change a statin or another lipid-lowering medicine without discussing it with your healthcare professional.

4. Choose a Heart-Healthy Eating Pattern

There is no single diabetes diet that works for everyone. A sustainable eating pattern should support glucose control and cardiovascular health while fitting your culture, preferences, medications and other health needs.

• Emphasize vegetables, legumes, whole or minimally processed foods and fiber-rich choices.
• Choose healthier unsaturated fats more often than saturated and trans fats.
• Watch portion sizes and total carbohydrate intake according to your treatment plan.
• Limit highly processed foods, sugary drinks and excess sodium.
• If you have kidney disease or another condition requiring dietary restrictions, obtain individualized nutrition advice.

The ADA's 2026 cardiovascular guidance supports dietary patterns such as Mediterranean- or DASH-style eating for appropriate patients, with attention to sodium, saturated fat, trans fat, fiber and overall dietary quality.

5. Stay Physically Active

Regular physical activity can support insulin sensitivity, blood pressure, fitness and cardiovascular health. A practical plan may combine aerobic activity, muscle-strengthening activity and flexibility or mobility work, depending on your health and fitness level.

• Start gradually if you have been inactive.
• Break up long periods of sitting where practical.
• Include resistance or muscle-strengthening activity when appropriate.
• If you have known heart disease, significant symptoms or exercise-related chest discomfort, ask your clinician what activity is safe for you.

6. Stop Smoking and Avoid Tobacco

Smoking increases cardiovascular risk and can worsen the health effects associated with diabetes. Quitting is one of the important modifiable steps for reducing cardiovascular risk. If you smoke, ask a healthcare professional about evidence-based cessation support rather than trying to manage withdrawal alone.

7. Take Medicines Exactly as Prescribed

Some people with diabetes need medicines for glucose, blood pressure, cholesterol or cardiovascular disease. Modern diabetes care may also include medicines selected partly for cardiovascular or kidney benefits when clinically appropriate. The right combination depends on your diagnosis, kidney function, cardiovascular history, other medicines and individual risk.

Never stop a prescribed medicine simply because you feel well. Ask your clinician or pharmacist before making changes, including over-the-counter medicines or supplements that could interact with your treatment.

8. Monitor More Than Blood Sugar

Diabetes care involves more than checking glucose. The 2026 ADA comprehensive evaluation includes assessment of cardiovascular risk factors, kidney health and other diabetes-related complications, with referrals to specialists when needed.

• Blood glucose and A1C, according to your care plan
• Blood pressure
• Lipid profile
• Kidney health
• Eye and foot health when indicated
• Weight, physical activity and other lifestyle factors

9. Manage Stress, Sleep and Daily Habits

Stress, poor sleep and an inconsistent routine can make healthy habits harder to maintain. Build a practical routine around regular meals, activity, medication-taking, sleep and follow-up appointments. If stress, anxiety or sleep problems are persistent, discuss them with your healthcare professional.

10. Know When to Seek Medical Care

Arrange a medical review when blood glucose, blood pressure or cholesterol remains outside your treatment goals, when medicines are causing side effects, or when new symptoms develop.

Seek emergency medical attention for symptoms such as new or severe chest pressure or pain, severe shortness of breath, fainting, sudden weakness or numbness, sudden difficulty speaking, or other symptoms that may indicate a heart attack or stroke.

Can a General Physician Help Manage Diabetes and Heart Risk?

A general physician can provide ongoing primary care for many people with diabetes, assess cardiovascular risk factors, monitor treatment, provide preventive care and coordinate specialist referrals when needed. More complex or established cardiovascular disease may require care from a cardiologist or another specialist alongside primary care.

Diabetes and Heart Disease: A Practical Daily Checklist

• Take medicines according to your prescribed schedule.
• Follow your individualized glucose and blood-pressure monitoring plan.
• Choose balanced meals and appropriate portions.
• Stay physically active within your medical limits.
• Avoid tobacco.
• Attend scheduled blood tests and medical appointments.
• Keep a record of important readings and questions for your next visit.

Frequently Asked Questions