Number 

2 

in a 

Series 

of 7 

Large-print version 

Prevent diabetes problems: 

Keep your heart and 


blood vessels healthy
 

U.S. Department 


of Health and
 

Human Services
 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse

 

Prevent diabetes problems: 

Keep your heart and
 

blood vessels healthy
 

U.S. Department 

of Health and 

Human Services 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
Contents 

What are diabetes problems? .............................................. 1
 

What should I do each day to stay healthy
 

What can I do to prevent heart disease
 

What can happen when blood vessels
 

How do narrowed blood vessels cause
 

How can clogged blood vessels hurt my
 

with diabetes? ...................................................................... 2
 

What do my heart and blood vessels do?............................ 3
 

and stroke?........................................................................... 4
 

How do my blood vessels get clogged?............................... 7
 

are clogged?......................................................................... 8
 

What are the warning signs of a heart attack?..................... 9
 

high blood pressure?.......................................................... 10
 

What are the warning signs of a stroke?............................ 12
 

legs and feet?..................................................................... 13
 

What can I do to prevent or control PAD? .......................... 14
 

Pronunciation Guide........................................................... 14
 

For More Information.......................................................... 15
 

More in the Series .............................................................. 17
 

Acknowledgments .............................................................. 18
 
 

 

 

What are diabetes problems? 

Too much glucose in the blood for a long time can cause 

diabetes problems. This high blood glucose, also called 

blood sugar, can damage many parts of the body, such 

as the heart, blood vessels, eyes, and kidneys. Heart and 

blood vessel disease can lead to heart attacks and strokes, 

the leading causes of death for people with diabetes. You 

can do a lot to prevent or slow down diabetes problems. 

This booklet is about heart and blood vessel problems 

caused by diabetes. You will learn the things you can do 

each day and during each year to stay healthy and prevent 

diabetes problems. 

Blood 

vessels 

Heart 

High blood glucose can 

cause heart and blood 

vessel problems. 

1 
 

What should I do each day to stay healthy 

with diabetes? 

Follow the healthy eating plan that you and your 

doctor or dietitian have worked out. 

Be active a total of 30 minutes most days. Ask 

your doctor what activities are best for you. 

Take your medicines as directed.
 

Check your blood glucose every day. Each time 

you check your blood glucose, write the number in 

your record book. 

Check your feet every day for cuts, blisters, sores, 

swelling, redness, or sore toenails. 

Brush and floss your teeth every day.
 

Control your blood pressure and cholesterol.
 

Don’t smoke.
 

2 
 

 

What do my heart and blood vessels do? 

Your heart and blood vessels make up your circulatory* 

system. Your heart is a muscle that pumps blood through 

your body. Your heart pumps blood carrying oxygen to large 

blood vessels, called arteries, and small blood vessels, 

called capillaries. Other blood vessels, called veins, carry 

blood back to the heart. 

Heart 

Artery 

Vein 

*See page 14 for tips on how 

to say the words in bold type. 

Capillary 

3 
 

 

 

 

 

 

 

 

What can I do to prevent heart disease and 

stroke? 

You can do a lot to prevent heart disease and stroke. 

l	 Keep your blood glucose under control. You can see 

if your blood glucose is under control by having an 

A1C test at least twice a year. The A1C test tells you 

your average blood glucose for the past 2 to 3 months. 

The target for most people with diabetes is below 7. 

In some people with heart disease or other special 

circumstances, their doctor may recommend slightly 

higher levels of A1C. 

l Keep your blood pressure under control. Have it
 

checked at every doctor visit. The target for most
 

people with diabetes is below 130/80.
 

l	 Keep your cholesterol under control. Have it checked 

at least once a year. The targets for most people with 

diabetes are 

• LDL—bad—cholesterol: below 100

• HDL—good—cholesterol: above 40 in men and
 

above 50 in women 

• triglycerides—another type of fat in the blood:

below 150 

4 
 

l Make physical activity a part of your daily routine. Aim 

for at least 30 minutes of exercise most days of the 

week. Check with your doctor to learn what activities 

are best for you. Take a half-hour walk every day. Or 

walk for 10 minutes after each meal. Use the stairs 

instead of the elevator. Park at the far end of the lot. 

Choose an activity you like and stay active. 

5 
 

 

 

 

 

l	 Make sure the foods you eat are “heart-healthy.” Include 

foods high in fiber, such as oat bran, oatmeal, wholegrain breads and cereals, fruits, and vegetables. Cut 

back on foods high in saturated fat or cholesterol, 

such as meats, butter, dairy products with fat, eggs, 

shortening, lard, and foods with palm oil or coconut 

oil. Limit foods with trans fat, such as snack foods and 

commercial baked goods. 

l	 Lose weight if you need to. If you are overweight, try 

to exercise most days of the week. See a registered 

dietitian for help in planning meals and lowering the fat 

and calorie content of your diet to reach and maintain a 

healthy weight. 

l	 If you smoke, quit. Your doctor can tell you about ways 

to help you quit smoking. 

l	 Ask your doctor whether you should take an aspirin 

every day. Studies have shown that taking a low dose 

of aspirin every day can help reduce your risk of heart 

disease and stroke. 

l	 Take your medicines as directed. 

6 
 

 

 

How do my blood vessels get clogged? 

Several things, including having diabetes, can make your 

blood cholesterol level too high. Cholesterol is a substance 

that is made by the body and used for many important 

functions. Cholesterol is also found in some food derived 

from animals. When cholesterol is too high, the insides of 

large blood vessels become narrowed or clogged. This 

problem is called atherosclerosis. 

Narrowed and clogged blood vessels make it harder for 

enough blood to get to all parts of your body. This condition 

can cause problems. 

Cross section of a healthy blood vessel 

Cross section of a narrowed blood vessel 

7 
 

 

 

 

 

 

 

 

 

What can happen when blood vessels 

are clogged? 

When blood vessels become narrowed and clogged, you 

can have serious health problems: 

l	 Chest pain, also called angina. When you have angina, 

you feel pain in your chest, arms, shoulders, or back. 

You may feel the pain more when your heart beats 

faster, such as when you exercise. The pain may go 

away when you rest. You also may sweat a lot and feel 

very weak. If you do not get treatment, chest pain may 

happen more often. If diabetes has damaged your 

heart nerves, you may not feel the chest pain. If you 

have chest pain with activity, contact your doctor. 

l	 Heart attack. A heart attack happens when a blood 

vessel in or near your heart becomes blocked. Then 

your heart muscle can’t get enough blood. When 

an area of your heart muscle stops working, your 

heart becomes weaker. During a heart attack, you 

may have chest pain along with nausea, indigestion, 

extreme weakness, and sweating. Or you may have no 

symptoms at all. If you have chest pain that persists, 

call 911. Delay in getting treatment may make a heart 

attack worse. 

l	 Stroke. A stroke can happen when the blood supply to 

your brain is blocked. Then your brain can be damaged. 

See page 12 for more information about strokes. 

8 
 

 

 

 

 

 

 

 

What are the warning signs of a heart 

attack? 

You may have one or more of the following warning signs: 

l chest pain or discomfort 

l pain or discomfort in your arms, back, jaw, or neck 

l indigestion or stomach pain 

l shortness of breath 

l sweating 

l nausea 

l light-headedness 

Or, you may have no warning signs at all. Warning signs 

may come and go. If you have any of these warning signs, 

call 911 right away. Getting prompt treatment can reduce 

damage to the heart. 

9 
 

 

How do narrowed blood vessels cause 

high blood pressure? 

Narrowed blood vessels leave a smaller opening for blood to 

flow through. Having narrowed blood vessels is like turning 

on a garden hose and holding your thumb over the opening. 

The smaller opening makes the water shoot out with more 

pressure. In the same way, narrowed blood vessels lead to 

high blood pressure. Other factors, such as kidney problems 

and being overweight, also can lead to high blood pressure. 

Many people with diabetes also have high blood pressure. If 

you have heart, eye, or kidney problems from diabetes, high 

blood pressure can make them worse. 

High pressure Low pressure 

A smaller opening in a garden hose makes the water pressure higher.
 

In the same way, clogged blood vessels lead to high blood pressure.
 

10 
 

 

 

 

 

 

 

You will see your blood pressure written with two numbers 

separated by a slash. For example, your reading might be 

120/70, said as “120 over 70.” For people with diabetes, the 

target is to keep the first number below 130 and the second 

number below 80. 

If you have high blood pressure, ask your doctor how to 

lower it. Your doctor may ask you to take blood pressure 

medicine every day. Some types of blood pressure medicine 

can also help keep your kidneys healthy. 

You may also be able to control your blood pressure by 

l eating more fruits and vegetables 

l eating less salt and high-sodium foods 

l losing weight if you need to 

l being physically active 

l not smoking 

l limiting alcoholic drinks 

To lower blood pressure, get to a 

healthy weight. 

11 
 

 

 

 

 

 

 

 

What are the warning signs of a stroke? 

A stroke happens when part of your brain is not getting 

enough blood and stops working. Depending on the part of 

the brain that is damaged, a stroke can cause 

l	 sudden weakness or numbness of your face, arm, or leg 

on one side of your body 

l	 sudden confusion, trouble talking, or trouble
 

understanding
 

l	 sudden dizziness, loss of balance, or trouble walking 

l	 sudden trouble seeing in one or both eyes or sudden 

double vision 

l	 sudden severe headache 

Sometimes, one or more of these warning signs may 

happen and then disappear. You might be having a “ministroke,” also called a TIA or a transient ischemic attack. If 

you have any of these warning signs, call 911 right away. 

Getting care for a TIA may reduce or prevent a stroke. 

Getting prompt treatment for a stroke can reduce the 

damage to the brain and improve chances for recovery. 

12 
 

How can clogged blood vessels hurt my 

legs and feet? 

Peripheral arterial disease, also called PAD, can happen 

when the openings in your blood vessels become narrow 

and your legs and feet don’t get enough blood. You may feel 

pain in your legs when you walk or exercise. Some people 

also have numbness or tingling in their feet or legs or have 

sores that heal slowly. 

13 
 

 

 

 

 

What can I do to prevent or control PAD? 

l Don’t smoke.
 

l Keep your blood glucose and blood pressure under
 

control. 

l Keep your blood fat levels close to normal. 

l Be physically active. 

l Ask your doctor if you should take aspirin every day. 

You also may need surgery to treat PAD. 

Pronunciation Guide
 

angina (an-JY-nuh)
 

arteries (AR-tur-eez)
 

atherosclerosis (ATH-ur-oh-sklur-OH-siss)
 

capillaries (KAP-ih-lair-eez)
 

circulatory (SUR-kyoo-luh-TOR-ee)
 

peripheral arterial disease (puh-RIF-ur-uhl)
 

(ar-TEE-ree-uhl) (dih-ZEEZ)
 

transient ischemic attack (TRANZ-see-uhnt)
 

(iss-KEE-mik) (uh-TAK)
 

14 
 

For More Information
 

Diabetes Teachers (nurses, dietitians, pharmacists, and 

other health professionals) 

To find a diabetes teacher near you, call the American 

Association of Diabetes Educators toll-free at 

1–800–TEAMUP4 (832–6874), or look on the Internet at 

www.diabeteseducator.org and click on “Find a Diabetes 

Educator.” 

Dietitians 

To find a dietitian near you, contact the American Dietetic 

Association at www.eatright.org and click on “Find a Nutrition 

Professional.” 

Government 

The National Heart, Lung, and Blood Institute (NHLBI) is 

part of the National Institutes of Health. To learn more about 

heart and blood vessel problems, write or call the NHLBI 

Health Information Center, P.O. Box 30105, Bethesda, MD 

20824–0105, 301–592–8573; or see www.nhlbi.nih.gov on 

the Internet. 

15 
To get more information about taking care of diabetes, contact
 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

National Diabetes Education Program 

1 Diabetes Way 

Bethesda, MD 20814–9692 

Phone: 1–888–693–NDEP (6337) 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndep@mail.nih.gov 

Internet: www.ndep.nih.gov 

American Diabetes Association 

1701 North Beauregard Street 

Alexandria, VA 22311 

Phone: 1–800–DIABETES (342–2383) 

Internet: www.diabetes.org 

Juvenile Diabetes Research Foundation International 

120 Wall Street 

New York, NY 10005–4001 

Phone: 1–800–533–CURE (2873) 

Internet: www.jdrf.org 

16 
 

More in the Series 

The “Prevent Diabetes Problems” Series has seven booklets 

that can help you learn more about how to prevent diabetes 

problems. 

For free single copies of these booklets, write, call, fax, or 

email the 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

These booklets are also available at 

www.diabetes.niddk.nih.gov on the Internet. 

17 
 

Acknowledgments 

The National Diabetes Information Clearinghouse thanks the 

people who helped review or field-test this publication: 

For the American 

Association of 

Diabetes Educators 

Lynn Grieger, R.D., C.D.E.
 

Arlington, VT
 

Celia Levesque, R.N.,
 

C.D.E. 

Montgomery, AL 

Teresa McMahon, 

Pharm.D., C.D.E. 

Seattle, WA 

Barbara Schreiner, R.N., 

M.N., C.D.E. 

Galveston, TX 

For the American 

Diabetes Association 

Phyllis Barrier, M.S., R.D., 

C.D.E. 

Alexandria, VA 

Linda Haas, Ph.C., R.N., 

C.D.E. 

Seattle, WA 

Kathleen Mahoney, M.S.N., 

R.N., C.D.E. 

Drexel Hill, PA 

Randi Kington, M.S., R.N., 

C.S., C.D.E. 

Hartford, CT 

For the Centers for 

Medicare & Medicaid 

Services 

Baltimore, MD
 

Jan Drass, R.N., C.D.E.
 

For the Diabetes Research 

and Training Centers 

Albert Einstein 

School of Medicine 

Norwalk Hospital 

Norwalk, CT 

Jill Ely, R.N., C.D.E. 

Sam Engel, M.D. 

Pam Howard, A.P.R.N., 

C.D.E. 

Indiana University 

School of Medicine 

Indianapolis, IN 

Madelyn Wheeler, M.S., 

R.D., F.A.D.A., C.D.E. 

VA/JDF Diabetes 

Research Center 

Vanderbilt School of 

Medicine 

Nashville, TN 

Ok Chon Allison, M.S.N., 

R.N.C.S., A.N.P., C.D.E. 

Barbara Backer, B.S. 

James W. Pichert, Ph.D. 

Alvin Powers, M.D. 

Melissa E. Schweikhart 

Michael B. Smith 

Kathleen Wolffe, R.N. 

For the Grady Health 

System Diabetes Clinic 

Atlanta, GA
 

Ernestine Baker, R.N.,
 

F.N.P., C.D.E. 

Kris Ernst, R.N., C.D.E. 

Margaret Fowke, R.D., L.D. 

Kay Mann, R.N., C.D.E. 

For the Indian Health 

Service 

Albuquerque, NM
 

Ruth Bear, R.D., C.D.E.
 

Dorinda Bradley, R.N., C.D.E.
 

Terry Fisher, R.N.
 

Lorraine Valdez, R.N.,
 

C.D.E. 

Red Lake, MN 

Charmaine Branchaud, 

B.S.N., R.N., C.D.E. 

For the Medlantic 

Research Center 

Washington, DC 

Resa Levetan, M.D. 

For the Texas Diabetes 

Council 

Texas Department of 

Health 

Austin, TX 

Luby Garza-Abijaoude, 

M.S., R.D., L.D. 

18 
 

 

 

 

 

 

 

 

National Diabetes 

Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health of the 

U.S. Department of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people with diabetes 

and to their families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works closely 

with professional and patient organizations and Government agencies to 

coordinate resources about diabetes. 

Publications produced by the Clearinghouse are carefully reviewed by both 

NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse encourages users 

of this booklet to duplicate and distribute as many copies as desired. 

This booklet is also available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications. When 

prepared, this publication included the most current information available. 

For updates or for questions about any medications, contact the U.S. Food 

and Drug Administration toll-free at 1–888–INFO–FDA (463–6332) or visit 

www.fda.gov. Consult your doctor for more information. 
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 09–4283L 

February 2009