Who is at risk for diabetes?
- Carrying body fat around the belly ("apple-shaped")
- Family history of diabetes
- Lack of exercise (fewer than 3 times a week)
- Impaired glucose tolerance in an earlier diabetes test
- Delivering a baby weighing more than 9 pounds or history of gestational diabetes
- High blood pressure
- Low HDL (good) cholesterol or high LDL (bad) cholesterol
- Polycystic ovary syndrome
- Certain ethnicities, including African American, Native American/Alaska Native, Asian American, Hispanic/Latino, and Native Hawaiian/Pacific Islander.
Diabetes is particularly widespread in African-American women, who are 50% to 60% more likely than white women to have heart failure, and develop heart failure at an earlier age.14
How can I prevent heart failure if I have diabetes?
The best way to prevent heart failure if you have diabetes is to get your high blood sugar levels under control and reduce your other risk factors. This means reducing your blood sugar, blood pressure, and cholesterol levels close to a normal value through lifestyle changes—especially diet and exercise—and medications, such as ACE inhibitors and angiotensin receptor blockers (ARB).15 The closer your numbers are to the optimal range, the better your chances are of preventing heart failure.
There are three major treatment goals to keep your diabetes under control: the ABCs of diabetes management. Following the ABCs of diabetes management lowers your risk of death due to diabetes and having complications of diabetes, including heart failure. Ask your doctor what your numbers are, what your individual goals should be, and what you need to do to reach and maintain them.
A is for A1C test (short for hemoglobin A1C). This simple blood test measures your average blood sugar over the last 3 months, and you should have it done at least twice a year. Aim to have an A1C level less than 7%.
B is for blood pressure. You should aim for a blood pressure less than 130/80. Have your blood pressure checked at every doctor's visit.
C is for cholesterol. Aim to have your LDL (bad) cholesterol less than 100 mg/dL. Have your cholesterol checked at least once a year.
Your health care provider can help you develop a plan for things you should do every day to take care of your diabetes, including following a healthy eating plan (eat your meals and snacks around the same time each day) and being physically active for a total of 30 minutes most days. If you have diabetes, you are at higher risk for many other diseases and problems. In addition to treating the diabetes itself, it is important to reduce other risk factors you have and to keep an eye out for other medical problems related to diabetes (such as vision or foot problems).
For more information:
- Schocken DD, Benjamin EJ, Fonarow GC, et al. Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation. May 13, 2008;117(19):2544-2565.
- Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol. Jul 1974;34(1):29-34.
- Galderisi M, Anderson KM, Wilson PW, Levy D. Echocardiographic evidence for the existence of a distinct diabetic cardiomyopathy (the Framingham Heart Study). Am J Cardiol. Jul 1 1991;68(1):85-89.
- Bell DSH. Diabetic Cardiomyopathy. Diabetes Care. October 1, 2003;26(10):2949-2951.
- Boudina S, Abel ED. Diabetic Cardiomyopathy Revisited. Circulation. June 26, 2007 2007;115(25):3213-3223.
- Heckbert SR, Post W, Pearson GDN, et al. Traditional Cardiovascular Risk Factors in Relation to Left Ventricular Mass, Volume, and Systolic Function by Cardiac Magnetic Resonance Imaging: The Multiethnic Study of Atherosclerosis. J Am Coll Cardiol. December 5, 2006;48(11):2285-2292.
- Rutter MK, Parise H, Benjamin EJ, et al. Impact of Glucose Intolerance and Insulin Resistance on Cardiac Structure and Function: Sex-Related Differences in the Framingham Heart Study. Circulation. January 28, 2003;107(3):448-454.
- Gustafsson I, Brendorp B, Seibaek M, et al. Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure. J Am Coll Cardiol. March 3, 2004 2004;43(5):771-777.
- Iribarren C, Karter AJ, Go AS, et al. Glycemic Control and Heart Failure Among Adult Patients With Diabetes. Circulation. June 5, 2001;103(22):2668-2673.
- Barr EL, Zimmet PZ, Welborn TA, et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation. Jul 10 2007;116(2):151-157.
- Ingelsson E, Sundstrom J, Arnlov J, Zethelius B, Lind L. Insulin Resistance and Risk of Congestive Heart Failure. JAMA. July 20, 2005;294(3):334-341.
- Nielson C, Lange T. Blood Glucose and Heart Failure in Nondiabetic Patients. Diabetes Care. March 1, 2005;28(3):607-611.
- Thrainsdottir IS, Aspelund T, Thorgeirsson G, et al. The Association Between Glucose Abnormalities and Heart Failure in the Population-Based Reykjavik Study. Diabetes Care. March 1, 2005;28(3):612-616.
- Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Jan 29 2008;117(4):e25-146.
- Hunt SA. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. September 20, 2005 2005;46(6):e1-82.