Heart disease is the second commonest cause of death in Canada. Almost 2.4 million Canadians are diagnosed with heart disorders. Besides, individuals with Type 1 diabetes are at a higher risk of heart disease as compared to the general population. Research has found that abnormal blood sugar levels damage the blood vessels supplying the heart, which results in cardiovascular disorders. The good news is that early treatment and maintaining sugar levels can significantly reduce the risk of heart disease and its complications.

If you are an adult who has Type 1 diabetes, it is important to consult your doctor and understand your risk of heart disorders.

Type 1 Diabetes and Heart Disease Causes

The exact link between Type 1 diabetes and heart diseases is not known. However, complications of Type 1 diabetes, such as high cholesterol levels, hypertension, and kidney disorders, can be responsible for it. High blood sugar levels itself can be responsible as it damages the nerves and blood vessels crucial for heart health and circulation. This can damage the nervous system, a condition known as neuropathy, which results in abnormalities of the vascular system as well.

Sugar is a sticky substance, and it combines with other substances in your blood vessels to form a blockage. It may also cause your blood vessels to harden. Furthermore, low sugar levels can alter electrical signals crucial for heart function.

Type 1 diabetes is an autoimmune condition, and people with Type 1 diabetes are at risk of having more than one autoimmune disorder. This can also involve autoimmune conditions affecting the heart. In some people with Type 1 diabetes, fluctuating blood sugar levels can cause injury to the heart. This can cause the immune system to affect the heart as much as it does to the pancreas.

Studies have also proved the link between abnormal glucose levels and cardiac autoimmunity.

Type 1 Diabetes and Heart Disease Risks

According to Diabetes Canada, some factors that increase the risk of cardiovascular disorders with Type 1 diabetes are:

  • Above 45 years of age
  • Hypertension
  • High cholesterol levels
  • Smoking

Type 1 Diabetes and Heart Disease Common Symptoms:

  • Breathlessness
  • Fatigue
  • Chest pain
  • Nausea
  • Sweating
  • Palpitations

Type 1 Diabetes and Heart Disease Diagnosis

If you are an adult living with Type 1 diabetes, your healthcare team may monitor your heart health regularly. Blood pressure should be checked at each visit to the doctor’s office. Getting a lipid profile is also recommended, the frequency of which depends on the age, sugar levels, and presence of other conditions.

Here are some additional tests the doctor might advise:

  • Electrocardiogram: It is a non-invasive and painless test that monitors the heart’s activity. The technician connects electrodes to arms, chest, and legs using a gel to measure the electrical heart activity at rest.
  • Doppler Ultrasound: It is also a non-invasive test and measures blood flow through the blood vessels and assess possible injuries. It involves the use of high-frequency sound waves and can be done for any major blood vessel supplying the heart, neck, and brain.
  • Coronary angiography: It is an invasive test that detects possible blocks in the blood vessels. In this test, a contrast dye is introduced in the veins, and the blood flow is monitored using an X-Ray.
  • Exercise stress test: Here, the electrocardiogram records the heart’s electrical activity while you exercise, usually on a treadmill.

Type 1 Diabetes and Heart Disease Guidelines

According to Diabetes Canada, ABCDE’S for Type 1 diabetes and heart disease are:

  • A: HbA1C or blood sugar level. The target is 7.0% or less.
  • B: Blood pressure. The target is 130/80 mmHg or less.
  • C: Cholesterol levels. The LDL-cholesterol level should be less than 2.0 mmol/L.
  • D: Drugs to protect your heart, which could include medications to manage blood pressure and cholesterol levels.
  • E: Eating and exercise. It involves healthy eating and regular physical activity to maintain normal body weight.
  • S: Managing stress and stop smoking.

Some tips to protect the heart with Type 1 diabetes:

  • Getting at least 150 minutes of moderate-intensity aerobic exercise per week.
  • Eating healthy (Mentioned below).
  • Maintaining normal weight.
  • Getting regular sleep.
  • Managing sugar levels.

Type 1 Diabetes and Heart Disease Treatment

Along with medications to manage blood pressure and cholesterol levels, certain medications to manage Type 2 diabetes also help in protecting the heart.

Some commonly used medications are:

  • Metformin
  • Sodium-glucose transport protein 2 inhibitors (SGLT2s)
    • Canagliflozin 
    • Empagliflozin
    • Dapagliflozin
    • Ertugliflozin
  • Glucagon-like peptide-1 (GLP-1) receptor agonists
    • Albiglutide
    • Exenatide
    • Lixisenatide
    • Dulaglutide
    • Liraglutide
    • Semaglutide

Type 1 Diabetes and Heart Disease Diet

Eating healthy is essential to maintain health, especially when you have Type 1 diabetes. To protect the heart, you should include healthy food choices:

  • Vegetables and fruits
  • Wholegrain
  • Fish
  • Non-processed meats
  • Nuts and pulses
  • Dairy products
  • Low-fat milk

It is also a good idea to limit the intake of sugary treats, salt, and fats.

Final Thoughts

Prevention and management of risk factors for heart disease are similar to that of the general population, including dietary changes, medications, and regular exercise. Have regular conversations with your doctor about the risks and any symptoms of a heart disorder that you may have.

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