People who are affected by either type 1 diabetes or type 2 diabetes are at higher risk of a future heart attack, stroke, or heart failure than people without diabetes. Unfortunately, these can sometimes be fatal. The actual risk increases with age. It is also higher in people with other health issues such as high blood pressure, eye disease, liver disease, kidney disease, sleep apnea, or smoking. The actual chance of heart attack or stroke or heart failure in a 60-year-old individual with diabetes who comes to a doctor’s office over the next 10 years is somewhere between 25% (1 in 4) and 50% (1 in 2).
Despite lots of research, we don’t understand all the reasons for this. Most scientists agree that it is related to the high glucose and related abnormalities that affect people with diabetes. These accelerate the aging process of the blood vessels throughout the body, including those that go to the brain and are part of the heart. Damage to these vessels increases their chance of getting clogged with debris in the form of clots that could deprive parts of the heart or the brain of oxygen and cause subsequent scar tissue. The lack of oxygen can cause heart tissue or brain tissue to die, which is what happens in a heart attack or stroke. The scar tissue can cause the heart to become stiff and not pump appropriately which leads to heart failure. The damaged blood vessels may contain calcium and plaque and when they get stiff, blood pressure rises.
The good news is that researchers have identified many ways to lower the chance that any of these serious events will occur. Multiple medications have been proven to reduce the likelihood of a fatal or non-fatal heart attack, stroke, or heart failure in people with type 2 diabetes.
Ongoing research is continuing to identify new ways of reducing and hopefully eliminating the higher risk of these serious outcomes in people with diabetes.
About the author
Hertzel Gerstein
Hertzel is an endocrinologist and professor at McMaster University who is in high demand as a speaker, advocate, and educator on diabetes-related topics. His research focuses on using large, international randomized trials to identify and test new ways of preventing type 2 diabetes, reducing serious health outcomes like strokes and death, and achieving type 2 diabetes remissions.