The relationship between diabetes and cardiovascular disease is clear, but the causes are complex. Over time, too much glucose in the blood damages nerves and blood vessels. This, in turn, can cause heart disease and stroke. In addition, damage to the blood vessels in the legs can result in poor circulation and increase the risk of foot ulcers and amputations, while damage to the blood vessels that supply blood to the kidneys can cause kidney failure and damage to the small blood vessels in the eye can eventually cause blindness.

If you have diabetes, your primary care physician may already have talked with you about the importance of taking care of your heart and blood vessels. If not, you should bring up the topic and ask your doctor to evaluate how high your risk for cardiovascular disease is and what you should do to prevent a heart attack, stroke, or peripheral artery disease (PAD).

Diabetes increases the risk of cardiovascular disease, making heart attack or stroke common causes of death among people with diabetes. Managing your diabetes is critical to heart health. The following questions can help you talk to your physician about how you can manage diabetes and work to safeguard your heart health at the same time.

Diabetes prevents the body from properly metabolizing sugar from food and using it as fuel in the body's cells. When you digest food, most of it is broken down into glucose, a type of sugar. The glucose is then transported in the blood to individual cells to burn for energy. Insulin, a hormone made by the pancreas, is needed to get the glucose into the cells — like a key that opens a door. In healthy people, the body automatically senses how much glucose is in the bloodstream and releases the right amount of insulin. In diabetes, the pancreas doesn't make enough insulin or the cells are resistant to the insulin, or both. As a result, the amount of glucose in the blood climbs too high while the cells starve for energy.