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).
These tests may include:
- Triglycerides, a kind of fat often elevated in people with diabetes
- Hemoglobin A1C, which measures average blood glucose levels over time
These diagnostic tests may include:
- Electrocardiogram (ECG), which records the electrical activity in your heart and can detect abnormalities that suggest the heart may not be getting enough blood flow in certain areas
This further testing may include:
- Stress testing, which evaluates how much blood flow is getting to the heart and how effectively the heart is pumping during exercise or another type of physical stress
- Echocardiography, which uses ultrasound to evaluate how well the heart is pumping and whether the heart muscle has become abnormally thick as a result of high blood pressure
- Coronary angiography, which involves threading a slender, flexible tube into the arteries of your heart and injecting x-ray dye to enable an interventional cardiologist to see inside your arteries, find any plaques and measure how severe they are
Testing for cholesterol plaque may include:
- Ultrasound, which uses sound waves to evaluate blood flow through the arteries
- Conventional angiography, which is similar to coronary angiography but involves arteries that supply blood to organs other than the heart
The ankle-brachial index (ABI) is also very helpful in diagnosing PAD in the legs and determining how severe it is. During an ABI test, your doctor will use a blood pressure cuff and a special ultrasound probe to compare blood pressure readings in the arm and lower leg on the same side of the body. If the blood pressure in the ankle is substantially lower than in the arm, it is a sign that a blockage is interfering with blood flow to the lower leg. The ABI provides important information for predicting the likelihood of serious problems such as foot wounds that won't heal or the need for surgery to restore blood flow to a limb.