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The heart is a vital organ that circulates blood throughout the body. The blood vessels that supply blood to the heart are known as coronary arteries, which also get affected in type 2 diabetes (T2D). The damage to the heart occurs not only due to artery damage but also nerve damage. This is why sometimes the major symptom of a heart attack, which is severe chest pain, may not be present in a person with T2D. The damage to the heart in T2D is known as Coronary Heart Disease (CHD).

Damage to the heart occurs according to how long a person has had T2D, how well it was controlled, and what other risk factors were present. Other common risk factors are high blood pressure, high cholesterol, smoking, and abdominal fat.

Coronary artery damage (CAD) includes thickening and hardening of the arterial walls. These arteries are then more likely to get clogged due to fatty deposits in their walls. The amount of blood that flows through them gets decreased and it makes the heart work harder to push the blood through them. In addition, the heart muscles do not get enough oxygen and nutrients to function normally.  The signs and symptoms of CHD may be vague or non-specific in T2D. However, if a person has had T2D for several years, they need to go for a checkup.

There maybe 4 signs of CAD due to diabetes. These include:

1. Angina – This could be a pain, pressure or squeezing feeling in your chest. This symptom occurs when the coronary arteries are unable to supply enough blood to the heart muscle. Sometimes the pain maybe in the arm, jaw, or back.  It may feel like indigestion, however, if the person has T2D they need to get checked for heart problems.
2. Arrhythmia – This is when the rhythm of your heart is off; you may feel that your heart flutters or misses a beat, or beats too fast. The damage here is in the electrical conduction nerves, which control the rhythm. Exactly how this damage is caused is not well understood. The danger here is that the abnormal rhythm may cause the heart to stop beating suddenly, causing collapse and even death if help is not around.
3. Heart attack – This occurs when an artery supplying one portion of the heart gets blocked. When it gets completely blocked and a part of the heart is suddenly not supplied with blood, the heart muscle starts dying. Generally there is severe chest pain on the left side of the sternum. In T2D this may not be present due to autonomic nerve damage. When there is a heart attack without the typical severe chest pain – it’s called a silent attack. The symptoms maybe vague such as sudden onset of weakness, cold sweating and feeling faint.
4. Heart failure – This starts to occur when the heart can no longer cope with effectively pumping the blood around the body. The heart might start becoming enlarged due to stress and weakened muscles. The body may begin feeling weak and tired; the legs or ankles start to swell due to fluid retention, the person may have trouble breathing or staying focused, and have a hard time exercising.

It is important to remember that damage to the heart does not occur in isolation. When blood vessel damage occurs in T2D it affects all the major arteries that supply the brain, eyes, kidneys and legs. This increases the risk for stroke, kidney problems and amputations, in addition to heart disease.

The trick is to control blood sugar levels as well as the other risk factors mentioned earlier. Living a healthy and well-balanced life, including eating a whole foods plant-based diet not only prevents lifestyle diseases like T2D but also helps control or delay the onset of complications in those who already have a lifestyle problem.  

Let me know your experiences with diabetes and its effects on the heart at Margaret@alchemusprime.com.