Could having type 2 diabetes affect my heart?

Unfortunately heart disease is common in people with type 2 diabetes.  There are a number of statistics which corroborate this

• Those with type 2 diabetes develop heart disease at a younger age than is typically average
• The most common cause of death in those with type 2 diabetes is a heart attack or stroke
• The overall risk of a heart attack or stroke is doubled in those with type 2 diabetes
• People with type 2 diabetes may have atypical or no symptoms of heart disease

There are several studies which indicate why this may be the case. Unfortunately these confirm that there is no one single cause because having type 2 diabetes can lead to hugely complex and negative consequences upon your health.

Type 2 diabetes and inflammation

We know having type 2 diabetes can cause a number of problems linked to high blood glucose levels and a high number of lipids. The raised sugar and fat levels cause something called “oxidative stress” which is when an excessive amount of oxygen free radicals are produced which then damages blood vessels and cause inflammation.

There is then a second consequence which was identified in a 2011 study. Normally such inflammation would be reduced by the body producing nitric oxide but this can only happen when an enzyme attaches itself to the inner membrane of a blood vessel with the help of something called a “fatty acid synthase” – or FAS.

Unfortunately, insulin resistance or deficiency restricts the production of FAS to low levels, which means the usual way in which a body would deal with inflammation is effectively blocked.  The consequence of this is that the blood vessels are much more vulnerable to damage overall.

Type 2 diabetes and vascular contraction

A study in 2016 demonstrated that higher blood sugar levels make blood vessels contract more than normal which could lead to increased blood pressure or a reduction in the amount of blood flowing to vital organs such as the heart or brain.

Type 2 diabetes and plaque in the arteries

As we know the build of up plaque in your arteries is a major health threat.  Unhealthy levels of lipids are a major contributory factor to this and we know that 97% of patients with type 2 diabetes have this problem.

What’s more the type of LDL cholesterol that people with type 2 diabetes produce are in smaller than usual particles which means they can more easily penetrate the arterial wall and become oxidised.

The presence of these oxidised particles is flagged as “foreign” to the immune system which is triggered into producing an abnormal amount of cells and leukocytes to deal with the problem. These can quickly cause the build-up of plaque.

Type 2 diabetes and small vessel disease

Many people already associate type 2 diabetes with nephropathy – a disease of the kidneys, neuropathy - a disorder of the nerves and retinopathy – damage to the retina which I explain here

These are all forms of “microvascular” disease or small vessel disease.

However, other small vessels in the body are also affected by type 2 diabetes - including those around the heart and brain.  This is due to diabetic autonomic neuropathy (or DAN) whereby nerve signals within blood vessels are interrupted. 

This negatively impacts upon the body’s ability to automatically increase blood flow at times when the body needs this to happen. There is very detailed information on this here

There are many more studies and theories but to sum up:  high blood glucose can damage the blood vessels and nerves around your heart and the longer you have the condition the more likely it is that you will develop heart disease.

The good news is that these problems are linked to type 2 diabetes which is preventable and reversible. You may want to read this blog post on the subject

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link