Whether it’s type 1 or type 2, having diabetes means a person is more likely to develop heart disease than those without the condition. They’re also more likely to develop heart problems at a younger age, and more likely to die from a related cardiovascular event, like a heart attack.
There are several factors playing into the development of diabetic heart disease. Here are some that may contribute to risk.
Cholesterol levels
Having high levels of LDL ("bad") cholesterol can increase the odds of developing diabetic heart disease, since LDL collects in arteries, slowing blood flow and adding to blockages. Low levels of HDL ("good") cholesterol also raise the chances; they're thought to guard against heart attack and stroke, and not having enough can be problematic. High triglycerides, another kind of blood fat, may also add to risk when combined with high LDL and low HDL.
Have you ever had a blood transfusion or organ transplant before 1992?
High blood pressure
Also called hypertension, high blood pressure occurs when blood pushes too hard against artery walls. A blood pressure reading of 130/80 mmHg or more is usually considered to be hypertensive. Having diabetes and high blood pressure doubles the risk of cardiovascular disease, and can raise the odds of stroke, kidney issues, and more. Among other things, excessive consumption of alcohol can raise blood pressure.
Smoking
Whether a person has diabetes or not, smoking raises the chances of developing heart problems. It damages blood vessels and reduces blood flow, lowering HDL cholesterol levels, worsening the effects of high LDL cholesterol, and limiting the transport of oxygen throughout the body. Over time, however, kicking the habit can lower the risk.
Excess weight
Being overweight or obese increases the risk of both diabetes and heart disease. Among other things, it raises the odds of developing high blood pressure and high LDL cholesterol, both central causes of cardiovascular disease. It’s also a contributor to insulin resistance, a major factor in both prediabetes and type 2 diabetes. Losing extra weight is proven to improve these conditions.
Inactivity and an unhealthy diet
Consuming too much sugar, saturated fat, trans fat, and sodium is connected to diabetic heart disease, as is not getting enough physical activity. Both contribute to obesity and high blood pressure, among other risk factors. Getting regular exercise—like running, walking, or gardening—and eating a healthy diet including fruits, vegetables, lean meats, and whole grains can help mitigate the risk.
Stress
A significant factor in heart disease, stress may lead to overeating, sleep issues, less physical activity, and smoking. It can also elevate blood pressure and heart attack chances.
Family history
Having close family members with heart disease—especially if they developed it before age 50—is strongly linked to a higher risk of heart issues.
Age
As people with diabetes get older, they’re more likely to develop heart problems than people without diabetes. Older people are also more likely than younger people to have heart disease.
Sources (7)
- National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, Heart Disease, & Stroke. April 2021.
- American Heart Association. Cardiovascular Disease and Diabetes. April 2, 2024.
- National Heart, Lung, and Blood Institute. Take Diabetes to Heart Fact Sheet. March 2020.
- MedlinePlus. Diabetic Heart Disease. April 10, 2024.
- American Heart Association. HDL Good, LDL Bad Cholesterol and Triglycerides. February 19, 2024.
- Johns Hopkins Medicine. Diabetes and High Blood Pressure. Accessed March 3, 2026.
- Centers for Disease Control and Prevention. Health Effects of Cigarettes: Cardiovascular Disease. September 17, 2024.