The best way to prevent or delay the development of cardiovascular disease is to prevent diabetes itself. Studies have proven that modest weight reduction and a 30-minute exercise routine five days a week can reduce the development of type 2 diabetes over three years by more than 50 percent. Moreover, even people at risk for diabetes or those with pre-diabetes, in addition to those with diabetes, frequently have abnormalities in blood pressure and lipid levels that can be detected and treated to prevent cardiovascular disease.

Weight control and smoking cessation also have an impact on preventing heart disease. Studies show that even in overweight people, regular physical activity has major cardiovascular benefits. Along with good control of blood glucose levels, a low-dose aspirin can add to these benefits. For A1C tests, the goal is less than 7 percent.

Diabetes by itself is the strongest risk factor for heart disease. In addition to blood glucose levels, other well-established risk factors, such as smoking, high cholesterol and high blood pressure, add to this risk. There is evidence that smoking, being overweight, having a sedentary lifestyle and poor blood glucose control contribute to the increased chance of high blood pressure and abnormalities in blood lipids: high cholesterol, high triglycerides and a low level of HDL cholesterol (the “good” cholesterol). Evidence also shows that, with diabetes, you can have an increased level of low-grade inflammation of your arterial lining, a process that initiates the blood vessel changes leading to heart disease.

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