If you have type 2 diabetes, you’ve likely been advised to monitor your blood sugar, eat healthy , and stay active. However, one important but overlooked aspect is that your heart also plays a crucial role. Heart disease, particularly a condition known as atherosclerotic cardiovascular disease (ASCVD), is a major cause of death in people with type 2 diabetes.¹

Let’s take a moment to understand how your blood sugar levels relate to your heart health.

What’s the link between type 2 diabetes and heart disease?
Everything starts inside your blood vessels. High blood sugar, over time, damages the delicate inner lining of your arteries.² Think of it like a well-paved road gradually developing cracks and potholes. These weak spots allow plaque (a sticky substance made up of fat, cholesterol, and debris) to collect and harden along the artery walls. This buildup is called atherosclerosis, and it can hinder blood flow throughout your body.³

When this happens, blood can’t flow as freely. Your heart, brain, and even your legs may not get enough oxygen. This raises the risk of heart attacks, strokes, and even peripheral artery disease (PAD), which affects blood flow to your limbs.^4,5

But it’s not just high blood sugar alone. People with diabetes are also more likely to have high blood pressure, unhealthy cholesterol levels, and high triglycerides, all of which further stress the heart.^6,7

Signs your heart may might be asking for help
Heart disease isn’t always obvious at the outset with dramatic signs. Sometimes, it shows subtle symptoms.⁸ Pay attention to:

• Shortness of breath, even when resting

• Pain in the jaw, back, neck, or arms

• Numbness or weakness in the legs

If you notice any of these symptoms, don’t ignore them; see your doctor right away.
Your gut-heart connection: More than just digestion

Did you know your gut plays a powerful role in your heart health? One of the key players in this connection is a hormone called GLP-1 (glucagon-like peptide-1), — but it’s not the only one alone.After you eat, your gut releases GLP-1 hormone^9-11, which:

• Stimulates insulin release from the pancreas to regulate blood sugar

• Slows digestion to help you feel full

• Supports healthier blood vessels

• May even lower the risk of heart attacks and strokes

But GLP-1 hormone works in harmony with other hormones like:

• Insulin – manages blood glucose levels

• Glucagon – balances insulin’s effects

• Ghrelin and l& Leptin – regulate hunger and satiety

• Cortisol – influences metabolism and stress response

Together, these hormones form a network of natural defenses that protect your heart, manage your weight, and support overall health.

While we’re not diving into treatments here, it’s reassuring to know that your body has natural defences like GLP-1 and insulin, and that researchers continue to uncover its broader health benefits.

Simple steps to get started today you can start today

Here’s the good news: you have more control than you might think.
Start with these heart-smart habits:

• Eat a balanced, heart-healthy diet¹²
• Get moving and aim for at least 30 minutes most days¹³
• Maintain a healthy weight¹⁴
• Keep your blood sugar, blood pressure, and cholesterol in check¹⁵
• Quit smoking (or never start!)¹⁶
• Limit alcohol and manage stress^{17, 18}
• Stay consistent with check-ups¹⁹

ET Spotlight

Don’t wait for a wake-up call
It’s easy to think of diabetes as a sugar problem. But your heart, brain, and blood vessels play a role too are on that ride too. The sooner you start making small changes, the better your chances of protecting your whole entire health, not just your blood sugar.

Remember, your heart works hard for you every day. Why not take good care of it and show some love in return?

References:

1. Gourdy P, Schiele F, Halimi J-M, Kownator S, Hadjadj S, Valensi P. Atherosclerotic cardiovascular disease risk stratification and management in type 2 diabetes: review of recent evidence-based guidelines. Frontiers in Cardiovascular Medicine. 2023;Volume 10 – 2023.
2. Aronson D, Rayfield EJ. How hyperglycemia promotes atherosclerosis: molecular mechanisms. Cardiovascular Diabetology. 2002;1(1):1.
3. He Z, Luo J, Lv M, Li Q, Ke W, Niu X, et al. Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques. Frontiers in neurology. 2023;14:1159288.
4. Ishar K. Thak * PRH, Ravindra L. Bakal and Om N. Ajmire. Atherosclerosis: Pathophysiology, risk factors, diagnosis and treatment GSC Biological and Pharmaceutical Sciences. 2025;30(3):112-7
5. Soehnlein O, Lutgens E, Döring Y. Distinct inflammatory pathways shape atherosclerosis in different vascular beds. European Heart Journal. 2025.
6. Committee ADAPP. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025. Diabetes Care. 2024;48(Supplement_1):S207-S38.
7. Yuge H, Okada H, Hamaguchi M, Kurogi K, Murata H, Ito M, et al. Triglycerides/HDL cholesterol ratio and type 2 diabetes incidence: Panasonic Cohort Study 10. Cardiovascular Diabetology. 2023;22(1):308.
8. Jurgens CY, Lee CS, Aycock DM, Masterson Creber R, Denfeld QE, DeVon HA, et al. State of the Science: The Relevance of Symptoms in Cardiovascular Disease and Research: A Scientific Statement From the American Heart Association. Circulation. 2022;146(12):e173-e84.
9. Huber H, Schieren A, Holst JJ, Simon MC. Dietary impact on fasting and stimulated GLP-1 secretion in different metabolic conditions – a narrative review. The American journal of clinical nutrition. 2024;119(3):599-627.
10. van Bloemendaal L, RG IJ, Ten Kulve JS, Barkhof F, Konrad RJ, Drent ML, et al. GLP-1 receptor activation modulates appetite- and reward-related brain areas in humans. Diabetes. 2014;63(12):4186-96.
11. Zhang X, Cao C, Zheng F, Liu C, Tian X. Therapeutic Potential of GLP-1 Receptor Agonists in Diabetes and Cardiovascular Disease: Mechanisms and Clinical Implications. Cardiovascular drugs and therapy. 2025.
12. Flores-Hernández MN, Martínez-Coria H, López-Valdés HE, Arteaga-Silva M, Arrieta-Cruz I, Gutiérrez-Juárez R. Efficacy of a High-Protein Diet to Lower Glycemic Levels in Type 2 Diabetes Mellitus: A Systematic Review. International journal of molecular sciences. 2024;25(20).
13. 30 minute daily walk helps prevent diabetes and age related diseases (2014). Available from Link; Accessed on 4 August 2025.
14. Committee ADAPP. 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes–2025. Diabetes Care. 2024;48(Supplement_1):S167-S80.
15. Sarah SC, Jean ML. Blood glucose, blood pressure, and cholesterol testing among adults with diabetes before and during the COVID-19 pandemic, USA, 2019 vs 2021. BMJ Open Diabetes Research & Care. 2023;11(3):e003420.
16. Australia WHOIDFTUoNC. (2023) Available from Link; Accessed on 4 August 2025.
17. Eshete A, Mohammed S, Deresse T, Kifleyohans T, Assefa Y. Association of stress management behavior and diabetic self-care practice among diabetes type II patients in North Shoa Zone: a cross-sectional study. BMC Health Services Research. 2023;23(1):767.
18. Nair S. The Impact of Alcohol Consumption on Diabetes Management and Outcomes: A Comprehensive Analysis. J Diabetes Metab. 2024;15(12):1195.
19. Your Diabetes Care Schedule (2024). Available from Link; Accessed on 4 August 2025.

This article is authored by Dr Reema Kashiva, Director, Centre of Excellence for Diabetes and Obesity, Noble Hospital, Pune.

This content is part of a disease awareness initiative by Novo Nordisk. The opinions and views are that of the Healthcare Professionals. The news and editorial staff of ET had no role in the creation of this article nor vouch for or endorse any of its content. While the content on this site provides general information about health and wellbeing. It is not intended as medical advice, nor is it a substitute for professional medical expertise or treatment. If you need help getting your health under control, we recommend speaking to your doctor.