U.S. Department 

of Health and 

Human Services 

Prevent diabetes problems
 

Number 

2 

in a 

Series 

of 7 

Keep your heart and 

blood vessels healthy

Keep your heart and 

blood vessels healthy 

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 

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

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

What can I do to prevent heart disease 

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

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

What can happen when blood vessels
 

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

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

How do narrowed blood vessels cause
 

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

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

How can clogged blood vessels hurt my 


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

What can I do to prevent or control PAD? .......... 13
 

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

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

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

Acknowledgments .................................................. 18
 
Blood 

vessels Heart 

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. 

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 
Heart 

Artery 

Vein 

Capillary 

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.
 

*See page 14 for tips on how 

to say the words in bold type. 

3 
What can I do to prevent heart 


disease and stroke?
 

You can do a lot to prevent heart disease and 


stroke. 


● 	 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. 

● 	Keep your blood pressure under control. Have 

it checked at every doctor visit. The target for 

most people with diabetes is below 130/80. 

● 	 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 
● 	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 
 

 

 

 

 

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

Include foods high in fiber, such as oat bran, 

oatmeal, whole-grain 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. 

● 	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. 

● 	If you smoke, quit. Your doctor can tell you 

about ways to help you quit smoking. 

● 	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. 

● 	Take your medicines as directed. 

6 
Cross section of a healthy blood vessel 

Cross section of a narrowed blood vessel 

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. 

7 
 

 

 

What can happen when blood 


vessels are clogged?
 

When blood vessels become narrowed and 


clogged, you can have serious health problems:
 

● 	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. 

● 	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. 

● 	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:
 

● 	 chest pain or discomfort 

● 	 pain or discomfort in your arms, back, jaw, 

or neck 

● 	 indigestion or stomach pain 

● 	 shortness of breath 

● 	 sweating 

● nausea 

● 	 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 
 

High pressure Low pressure 

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. 

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 

● 	eating more fruits and vegetables 

● 	eating less salt and high-sodium foods 

● 	 losing weight if you need to 

● 	being physically 

active 

● 	not smoking 

● 	 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
 

● 	sudden weakness or numbness of your 

face, arm, or leg on one side of your body 

● 	sudden confusion, trouble talking, or 

trouble understanding 

● 	sudden dizziness, loss of balance, or 

trouble walking 

● 	sudden trouble seeing in one or both eyes 

or sudden double vision 

● 	sudden severe headache 

Sometimes, one or more of these warning signs 

may happen and then disappear. You might be 

having a “mini-stroke,” 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.
 

What can I do to 


prevent or control PAD?
 

● 	Don’t smoke. 

● 	Keep your blood glucose and 


blood pressure under control.
 

● 	Keep your blood fat levels close to 

normal. 

● 	Be physically active. 

● 	Ask your doctor if you should take aspirin 

every day. 

You also may need surgery to treat PAD. 

13
 
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 

to prevent diabetes problems. 

The “Prevent Diabetes Problems” Series has seven 


booklets that can help you learn more about how 


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 

this booklet. 

The National Diabetes Information Clearinghouse 


thanks the people who helped review or fi eld-test 


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
 
19

 

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. 
NIH Publication No. 09–4283

February 2009

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

National Institutes of Health