News and insights brought to you by the International Diabetes Federation

Diabetes advocate, Atul Yoke, taking his blood pressure.

Cardiovascular disease (CVD) is a major global health concern and the primary cause of death in high-income countries. CVD affects the heart and blood vessels, causing serious complications such as heart attack and stroke. It is expected to become the leading cause of mortality in many low- and middle-income countries, reaching levels similar to high-income countries. CVD is the most common cause of death in people with diabetes, who have a threefold risk of developing cardiovascular complications.

The two life-threatening CVD-related complications for people with diabetes are heart attack and stroke. A third complication, peripheral arterial disease (PAD), affects the blood flow to the arms and feet. PAD is more common in people with diabetes, and about half of people with diabetes-related foot complications will also have PAD.

Diabetes now rivals smoking, high blood pressure and lipid disorders as a major risk factor for cardiovascular disease.

The signs and symptoms of CVD

At first, there may not be any apparent signs and symptoms of CVD. However, if the condition progresses, symptoms can appear depending on the type of CVD. These symptoms include shortness of breath, fatigue, dizziness or fainting, irregular heartbeat, swollen feet and ankles and chest pain.

It is worth noting that people with diabetes may not experience chest pain due to nerve damage in the heart. If you notice any symptoms that could indicate CVD, consult with your healthcare provider for further evaluation and guidance.

Knowing the risks

Being aware of the CVD risk factors can help people with diabetes, their caregivers and healthcare professionals implement strategies to prevent or limit cardiovascular complications. Risk factors for people with diabetes include chronic kidney disease (CKD), high blood pressure, lipid imbalance (dyslipidemia) and obesity. Women with diabetes can be at risk of pre-eclampsia, a pregnancy complication which can also cause CVD. Some of these risks are avoidable or can be reduced through behavioural changes and lifestyle interventions. Others, such as age, gender, ethnicity and family history, are not, so knowing the risks is essential to delay or prevent complications.

Being aware of the CVD risk factors can help people with diabetes, their caregivers and healthcare professionals implement strategies to prevent or limit cardiovascular complications.

Developing strategies to reduce CVD risk

Effectively managing goes hand in hand with maintaining optimal heart health. Healthy lifestyle habits, including a balanced diet with attention to the glycaemic index of foods and regular physical activity, are vital for managing diabetes and improving heart health. Likewise, monitoring blood glucose and managing high blood pressure and cholesterol contribute to lowering CVD risk. By prioritising heart health, people with diabetes can reduce the risk of cardiovascular complications and improve their overall well-being.

Two additional behavioural risk factors are smoking and excessive alcohol consumption. Both increase the risk of CVD in general and more so in people with diabetes. For smokers with diabetes and their healthcare providers, it is highly recommended that they work together to implement a strategy to stop smoking.

Meanwhile, a statement published by the World Health Organization in 2023 declared that no level of alcohol consumption is safe for our health. For people with diabetes, drinking alcohol can cause low or high blood glucose, affect diabetes medicines and possibly cause other complications.

Tackling additional risks through a multi-sectoral approach

Further modifiable risk factors linked to economic, environmental and societal conditions are a low weight or premature birth, exposure to air pollution, low socioeconomic status, mental health issues, social isolation and lack of awareness. While many risk factors mentioned previously can be tackled with proper management and healthcare advice, these require a multisectoral approach. Through collaboration, partners can leverage expertise, reach and resources to diminish these external CVD risks for people with diabetes and improve health outcomes.

IDF research indicates that many people with diabetes are unaware of CVD and its risk factors and rely on healthcare professionals as a source of information on prevention and treatment. Healthcare professionals are crucial in helping people understand the risks and implementing early intervention, but they are not the only key players. Diabetes associations, community support groups and advocates contribute to awareness raising, education and policy development. Together, they can empower people with diabetes and their caregivers to develop effective strategies to limit cardiovascular complications.

Learn more about CVD and diabetes-related risks

Take the IDF School of Diabetes course on Type 2 diabetes and the heart. This 30-minute course — designed for people with diabetes and their carers — covers the impact of diabetes on heart health and diabetes management strategies for optimal heart health. Learning points also address how to reduce the risk of diabetes-related complications, such as heart disease and stroke. Upon completing four interactive modules, learners will better understand the key health indicators to monitor for effective management of diabetes and heart health.

Go to the course at IDF School of Diabetes and start learning now!


Justine Evans is Content Editor at the International Diabetes Federation

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