People with diabetes are highly susceptible to atherosclerosis—the buildup of deposits called plaques, which form in large arteries. Plaques narrow arteries and can reduce blood flow to the heart, a condition called coronary heart disease (CHD).
Partial blockage of the coronary arteries produces angina (chest pain); complete blockage results in a heart attack. Atherosclerosis can also lead to strokes (blockage of blood flow to the brain) and peripheral arterial disease (poor blood flow to the legs). These complications are the cause of death in three quarters of people with diabetes. That's why experts say controlling cardiovascular disease risk factors is just as important as controlling your blood glucose levels.
People with diabetes have a two to four times greater likelihood of CHD than people without diabetes. CHD also tends to appear at an earlier age in people with diabetes. Studies show that diabetes adds significantly to other CHD risk factors such as smoking, high blood pressure, elevated LDL cholesterol levels, and low HDL cholesterol levels. In fact, a Finnish study found that people with type 2 diabetes who have no history of CHD have the same risk of a heart attack as those without diabetes who have already had a heart attack.
When elevated blood glucose levels occur together with high blood pressure, abdominal obesity, high blood triglyceride levels, and low HDL cholesterol levels, this is called the metabolic syndrome. This cluster of risk factors puts people at an especially high risk for CHD (and diabetes).
People with diabetes are also two to four times more likely to have a stroke than those without diabetes. High blood glucose likely increases the risk of stroke by promoting atherosclerosis. Also, high blood pressure—one of the most important stroke risk factors—is twice as common in people with diabetes.