Preventing Heart Disease in Type 2 Diabetes

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A 2017 review published in the Journal of the American College of Cardiology examined the evidence behind guidelines for exercise, nutrition, and weight management, as well as managing blood pressure, blood lipids, blood sugar, and aspirin use, to create a comprehensive plan to reduce the risk of heart disease.

The authors concluded that the following multifaceted approach offers the best way to prevent heart disease in people with type 2 diabetes:

  • At least 150 minutes per week of moderate-intensity physical activity, spread out over three or more days per week
  • A Mediterranean-style diet and/or carbohydrate monitoring
  • Lifestyle changes that help overweight people reduce their body weight by 3 to 5 percent
  • Smoking cessation
  • Maintaining an A1c level at or below 7 percent for most patients; below 6.5 percent for those who have a relatively long life expectancy or for whom little time has passed since diagnosis, if such a target can be reached safely
  • Lowering blood pressure to below 140/90 mm Hg for most; below 130/80 mm Hg for younger people with multiple cardiovascular (CV) risk factors, if such a level can be safely achieved
  • Statin therapy for individuals with LDL 70-189 mg/dL
  • Aspirin therapy for those 50 and over with at least one CV risk factor and no increased gastrointestinal bleeding risk

Bottom line: Ask your doctor how these new guidelines apply to you before making any medication or lifestyle changes.