Keep Your Heart Strong with Diabetes!
D-coding the Article- : Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025
Published Date:
1st Jan, 2025
Published By:
American Diabetes Association Professional Practice Committee
Approved By:
To be
Decoded By:
Asra H. Ahmed
MBA, PGCE in Assessment Learning disability, Diabesties Foundation
10 mins to read
- The T1D Takeaway
- Managing Type 1 Diabetes isn’t just about blood sugar—protecting our heart through regular check-ups, healthy eating, exercise, and stress management is just as important for a long, healthy life.
Word Wizard
- Heart health is a key priority for people living with Type 1 Diabetes (T1D), as they face a higher risk of heart disease—even with well-managed blood sugar.
- The American Standard of Care recommend regular screenings of Blood pressure, cholesterol, and heart health should be checked regularly to catch risks early.
- To further reduce the risk, people living with Type 1 Diabetes should be encouraged to adopt heart-healthy habits.
- This includes prioritizing nutritious foods rich in fiber and healthy fats while limiting processed foods and excess sugar.
- Regular physical activity, even simple movements like walking, supports both heart health and glucose control.
- For those at risk of high blood pressure or cholesterol issues, heart-friendly medications may be beneficial under medical guidance.
- Additionally, managing stress and ensuring quality sleep play a crucial role in maintaining both blood sugar levels and overall cardiovascular health.
- T1D management is not just about glucose—heart health must be a top priority for long-term well-being.
Summary Snap
Shots
People with Type 1 Diabetes can support heart health through regular screenings, a nutritious diet, physical activity, stress management, quality sleep, and, when needed, heart-friendly medications.
Prime Insight
The American Diabetes Association (ADA) Standards of Care provide the latest evidence-based guidelines for managing diabetes, aiming to improve health outcomes and prevent complications.
People with diabetes, including Type 1, have a higher risk of heart disease, strokes, and circulation problems. Keeping blood sugar, blood pressure, and cholesterol in check together helps lower these risks and improves long-term health.
Most cardiovascular risk reduction strategies are based on Type 2 Diabetes studies, and similar recommendations are applied to people with Type 1 Diabetes due to a lack of T1D-specific trials.
Check blood pressure regularly—at every visit or at least every 6 months.
Diabetes raises the risk of heart failure, especially with high blood pressure, obesity, or heart disease. Regular blood pressure checks are important, with a target of below 130/80 mmHg if safe. If readings are high, multiple checks confirm hypertension, and home monitoring helps track and manage it better.
For pregnant individuals with diabetes and chronic hypertension, treatment is started at 140/90 mmHg, with a suggested goal between 110–135/85 mmHg to ensure maternal and fetal health.
Aim for <130/80 mmHg if safe, to lower heart failure risk.
People with blood pressure above 120/80 mmHg can benefit from lifestyle changes, including a heart-healthy diet rich in fruits, vegetables, and potassium while reducing sodium intake (DASH-style eating), along with regular exercise of at least 150 minutes per week. Maintaining a healthy weight, limiting alcohol, and quitting smoking further support blood pressure control. If these changes aren’t enough, blood pressure-lowering medications may be recommended based on individual risk and health needs.
If lifestyle changes alone aren’t enough, blood pressure-lowering medications should be used based on individual risk and needs.
- A Deeper Dive
- The Sources Voice
“Under the current paradigm of comprehensive risk factor modification, cardiovascular morbidity and mortality have notably decreased in people with both type 1 and type 2 diabetes. Therefore, continued focus on delivering high-quality comprehensive cardiovascular care and on addressing barriers to risk factor management are required to implement the treatment recommendations.”
- Curiosities Clarified
Diabetes significantly increases the risk of atherosclerotic cardiovascular disease (ASCVD), heart failure, and chronic kidney disease (CKD). Managing cardiovascular risk factors leads to reduced morbidity and mortality.
SGLT2 inhibitors and GLP-1 receptor agonists (GLP-1 RAs) should be prioritized for people with T2D with or at high risk for ASCVD, heart failure, or CKD, even if additional glucose lowering is not needed. Blood pressure management, with ACE inhibitors or ARBs recommended for those with hypertension and diabetes. Lipid management, emphasizing the use of statins, PCSK9 inhibitors, and ezetimibe for LDL cholesterol control. Aspirin and antiplatelet therapy for secondary prevention in individuals with existing ASCVD.
Routine screening for asymptomatic coronary artery disease is not recommended unless it would change management.
Ankle-brachial index (ABI) screening for peripheral artery disease (PAD) is recommended in select high-risk individuals. Echocardiography should be considered for people with high NT-proBNP levels to detect early-stage heart failure.
Early and aggressive management of cardiovascular risk factors is essential in diabetes. SGLT2 inhibitors and GLP-1 RAs are now considered fundamental parts of cardiovascular and kidney risk management in T2D.
Blood pressure and lipid management should be individualized, but guideline-recommended targets should be pursued. Screening for cardiovascular disease should be selective, avoiding unnecessary tests in asymptomatic individuals.
Implementation gaps exist, requiring better patient education, access to therapy, and adherence to guidelines.
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