Don’t miss a beat in type 2 diabetes

It is important to be aware of the link between type 2 diabetes and cardiovascular disease.

 

What is cardiovascular disease?

Cardiovascular disease describes some of the problems that result from narrow or blocked blood vessels. This includes problems like chest pain (also known as angina), heart attack or stroke. If you have type 2 diabetes, you are at a higher risk of developing cardiovascular disease, which could be fatal.

 

What can you do?

The good news is that cardiovascular disease can be preventable and there are lots of things you can do to lower your potential risk. To learn more, take a look at the 'don’t miss a beat in type 2 diabetes' animation, narrated by Christopher Biggins who lives with type 2 diabetes.

 

Find out more about whether you are at risk of cardiovascular disease:

The seven questions below look at some of the risk factors for cardiovascular disease. Please select one answer for each question. Once you’ve answered all seven questions, you will be able to download information for you to keep. This will help you to recognise the factors that may be increasing your risk of cardiovascular disease and you can also use this information to discuss with your doctor or nurse how to lower your risk.

Your cardiovascular risk

Q1
How would you describe your ethnicity?
White White
South Asian South Asian
Other Asian Other Asian
Caribbean Caribbean
African African
Chinese Chinese
Mixed ethnicity Mixed ethnicity
Other ethnic group Other ethnic group
Your ethnicity does not increase your cardiovascular risk
Your ethnicity may increase your cardiovascular risk
Your ethnicity may increase your cardiovascular risk
Your ethnicity may increase your cardiovascular risk
For people with your ethnic background, the risk of cardiovascular disease can be lower versus people from South Asian, African or Caribbean background. However, you may still be at risk due other risk factors. If you are of a South Asian, African or Caribbean background, your cardiovascular risk can be higher than for others. While you cannot change this risk factor you should speak to your doctor or nurse at your next appointment to ensure that your risk is being addressed and you are managing other risk factors. For people who are of South Asian, African or Caribbean background, their cardiovascular risk can be higher than for others. If you are of mixed ethnicity including one or more of these three ethnic groups, while you cannot change this risk factor, you should speak to your doctor or nurse at your next appointment to ensure that your risk is being addressed and you are managing other risk factors.

If your ethnic background does not include South Asian, African or Caribbean, cardiovascular disease is less common in people with your ethnic background, but you may still be at risk due to other risk factors.
People of South Asian, African or Caribbean background may have an increased risk of cardiovascular disease versus other ethnicities.

If your ethnic background does not include South Asian, African or Caribbean cardiovascular disease is less common in people with your ethnic background, but you may still be at risk due to other risk factors.
Q2
Are you a smoker?
Yes Yes
No No
Smoking is not a risk factor for you
Smoking is a cardiovascular risk
Smoking is not a risk factor for you.

If you are an ex-smoker, by not smoking you have reduced your risk of developing diabetes-related complications such as heart disease or stroke. After a year of not smoking, your risk is halved, which is great news. Seek support from your doctor or nurse if you feel tempted to start smoking again.
Chemicals in cigarette smoke can damage your blood vessels, which can lead to the build-up of fatty material. This narrows the space within blood vessels which can mean that not enough blood and oxygen reaches the heart muscle, causing symptoms like chest pain and shortness of breath. Smoking can also raise blood pressure. Over time, if blood pressure is consistently high it can cause the heart to enlarge because it’s having to work harder, meaning it doesn’t work as well in the long term.

Smoking puts you at significant risk of developing diabetes-related complications such as heart disease or stroke. Stopping smoking will reduce your risk and after one year of not smoking, your risk is halved. Ask your doctor, nurse or pharmacist for support to help you quit and lower your risk.
Q3
What is your body mass index (BMI)?

If you’re not sure, check here

Underweight BMI is less than 18.5
Normal weight BMI is 18.5 to 24.9
Overweight BMI is 25 to 29.9
Obese BMI is 30 or more
Your BMI indicates you may be at greater risk
Your BMI indicates you may be underweight
Your BMI indicates you are a normal weight
Being overweight may cause both your blood pressure and cholesterol levels to increase. These are both cardiovascular risk factors that often increase as your body mass index increases.

Losing weight can be very difficult, but it is important for your long-term health including your risk of having a heart attack or stroke. There is a lot of good information on www.diabetes.org.uk to help you lose weight and you can also speak to your doctor or nurse at your next appointment about how they can support you.
Being underweight may have an impact on your health. Speak to your doctor or nurse at your next appointment about reaching a healthy weight. A BMI within the normal weight range reduces your cardiovascular risk. Maintaining a healthy diet and exercising, can help you remain at a healthy weight. If you are worried about your weight, please speak to your doctor or nurse for advice and support.
Q4
Do you meet targets for HbA1c (sometimes called blood sugar) set by your doctor or nurse?

If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below.

Always meet targets Always meet targets
Sometimes meet targets Sometimes meet targets
Rarely meet targets Rarely meet targets
Never meet targets Never meet targets
I don’t know I don’t know
You may be at risk of cardiovascular disease
It’s important to know your HbA1c levels and set a target with your doctor or nurse
You are helping to manage your risk
High HbA1c (blood sugar) levels can damage the inner lining of blood vessel walls, weakening the way they work. Over time, this can lead to type 2 diabetes-related complications, including cardiovascular disease. It is important that you have an HbA1c test at least once a year. An HbA1c blood test measures your overall blood sugar control over the previous three months. The test helps you and your doctor or nurse to set your diabetes targets and ensure they’re being met.

It’s important that your blood sugar is controlled. Speak to your doctor or nurse about what can be done to help reach your target HbA1c level and reduce your risk of developing cardiovascular disease and other long-term complications.
High HbA1c (blood sugar) levels can damage the inner lining of blood vessel walls, weakening the way they work. Over time, this can lead to type 2 diabetes-related complications, including cardiovascular disease. It is important that you have an HbA1c test at least once a year. An HbA1c blood test measures your overall blood sugar control over the previous three months. The test helps you and your doctor or nurse to set your diabetes targets and ensure they’re being met.

It’s important to know your HbA1c levels and meet the recommended targets for healthy management of type 2 diabetes. If you’ve not had an HbA1C blood test within the last 12 months, make an appointment with your doctor or nurse.
High HbA1c (blood sugar) levels can damage the inner lining of blood vessel walls, weakening the way they work. Over time, this can lead to type 2 diabetes-related complications, including cardiovascular disease. It is important that you have an HbA1c test at least once a year. An HbA1c blood test measures your overall blood sugar control over the previous three months. The test helps you and your doctor or nurse to set your diabetes targets and ensure they’re being met.

Ensure you are reviewing your HbA1c levels with your doctor or nurse at least once a year to continue having good control of your blood sugar.



Zinc ID: UK/CC/1018/0035

Date of preparation: November 2018

Your cardiovascular risk

Q5
Do you meet targets for cholesterol levels?

The NICE* recommended target level is less or equal to 5 mmol/L.

Always meet targets Always meet targets
Sometimes meet targets Sometimes meet targets
Rarely meet targets Rarely meet targets
Never meet targets Never meet targets
I don’t know I don’t know

* National Institute for Health and Care Excellence

You may be at risk of cardiovascular disease
It’s important to know your cholesterol levels and set a target with your doctor or nurse
You are helping to manage your risk
High cholesterol can increase the chances of plaque (fatty deposits) building up on blood vessel walls, narrowing blood vessels and affecting blood flow to your heart muscle and brain. If less blood and oxygen are able to reach the heart muscle this causes symptoms like chest pain or shortness of breath. If blood vessels reaching the heart muscle or brain become blocked there is a serious risk of heart attack or stroke.

It’s important to reduce your cholesterol to lower your risk of cardiovascular disease. Ask your doctor or nurse for advice and support to help you reach your targets and ensure your cholesterol levels are reviewed at least once a year.
High cholesterol can increase the chances of plaque (fatty deposits) building up on blood vessel walls, narrowing blood vessels and affecting blood flow to your heart muscle and brain. If less blood and oxygen are able to reach the heart muscle this causes symptoms like chest pain or shortness of breath. If blood vessels reaching the heart muscle or brain become blocked there is a serious risk of heart attack or stroke.

Ask your doctor or nurse to check your cholesterol at your next appointment so that you can set a target together. Reaching and maintaining your target for cholesterol is an important part of managing type 2 diabetes and it should be reviewed at least once a year.
High cholesterol can increase the chances of plaque (fatty deposits) building up on blood vessel walls, narrowing blood vessels and affecting blood flow to your heart muscle and brain. If less blood and oxygen are able to reach the heart muscle this causes symptoms like chest pain or shortness of breath. If blood vessels reaching the heart muscle or brain become blocked there is a serious risk of heart attack or stroke.

Keeping your cholesterol levels below 5 mmol/L is helping to reduce your risk of developing cardiovascular disease. Keep up the good work, and ensure your levels are reviewed at least once a year.
Q6
Do you meet targets for blood pressure levels?

If you have diabetes (or if you have had a heart attack, stroke or coronary heart disease) your blood pressure should be no higher than 130/80 mmHg.

Always meet targets Always meet targets
Sometimes meet targets Sometimes meet targets
Rarely meet targets Rarely meet targets
Never meet targets Never meet targets
I don’t know I don’t know
You may be at risk of cardiovascular disease
It’s important to know your blood pressure and set a target with your doctor or nurse
You are helping to manage your risk
High blood pressure can cause blood vessels to narrow, rupture or leak making it harder for blood carrying oxygen and nutrients to reach vital organs such as the heart muscle and brain. High blood pressure can also cause the heart to enlarge because it’s having to work harder, making it less effective in the long-term and this can result in a heart attack. Continued damage to blood vessels that supply the brain can cause a stroke.

It’s important to bring your blood pressure down to the recommended target. Speak to your doctor or nurse for support on how you can reduce your blood pressure and continue to review it at least once a year.
High blood pressure can cause blood vessels to narrow, rupture or leak making it harder for blood carrying oxygen and nutrients to reach vital organs such as the heart muscle and brain. High blood pressure can also cause the heart to enlarge because it’s having to work harder, making it less effective in the long-term and this can result in a heart attack. Continued damage to blood vessels that supply the brain can cause a stroke.

Your blood pressure should be measured and recorded at least once a year. At your next appointment, ask for your blood pressure to be measured and, if necessary, what you can do to bring your blood pressure down to the recommended target level.
High blood pressure can cause blood vessels to narrow, rupture or leak making it harder for blood carrying oxygen and nutrients to reach vital organs such as the heart muscle and brain. High blood pressure can also cause the heart to enlarge because it’s having to work harder, making it less effective in the long-term and this can result in a heart attack. Continued damage to blood vessels that supply the brain can cause a stroke.

Keeping your blood pressure within the recommended range is an important way to lower your risk of developing cardiovascular disease. Make sure you have your blood pressure measured and recorded at least once a year.
Q7
Is your waist more than 94cm (37 inches) if you’re male or more than 80cm (31.5 inches) if you’re female when measured all the way around?
Yes Yes
No No
I don’t know I don’t know
Your waist measurement may increase your cardiovascular risk
Your waist measurement does not increase your risk
Work out your waist circumference by measuring all the way round your waist
Carrying too much fat around your waist can increase your risk of cardiovascular disease, even if you have a healthy BMI. Fat around the tummy, called visceral fat, is a signal of the level of fat coating vital organs, such as the heart, and this can affect your blood sugar and cholesterol.

If your waist is more than 94cm (37 inches) if you’re male or more than 80cm (31.5 inches) if you’re female then it is really important to lose weight and reduce your waist measurement. There is a lot of good information on www.diabetes.org.uk to help you lose weight and you can also speak to your doctor or nurse at your next appointment about how they can support you.

If your waist measures more than 102cm (40ins) if you’re male or more than 88cm (34ins) if you’re female then your risk is very high and you should speak to your doctor or nurse.
Carrying too much fat around your waist can increase your risk of cardiovascular disease, even if you have a healthy BMI. Fat around the tummy, called visceral fat, is a signal of the level of fat coating vital organs, such as the heart, and this can affect your blood sugar and cholesterol.

Keeping your waist circumference (the measurement when taken all the way around your waist) within a healthy range is helping to reduce your cardiovascular risk.
Carrying too much fat around your waist can increase your risk of cardiovascular disease, even if you have a healthy BMI. Fat around the tummy, called visceral fat, is a signal of the level of fat coating vital organs, such as the heart, and this can affect your blood sugar and cholesterol.

It is important to know your waist circumference (the measurement when taken all the way around your waist) and keep it within a healthy range.

To measure your waist:
  1. Find the bottom of your ribs and the top of your hips
  2. Wrap a tape measure around your waist, midway between these points
  3. Breathe out naturally before taking the measurement.

Your waist should measure less than 94cm (37 inches) if you’re male or less than 80cm (31.5 inches) if you’re female. If you find that your waist measures more than this, you should speak to your doctor or nurse as you may be at risk of cardiovascular disease.



Zinc ID: UK/CC/1018/0035

Date of preparation: November 2018

Once you’ve answered all the questions, click the DOWNLOAD PDF button below to save a copy of the information sheet related to your answers. You may wish to print this to discuss the cardiovascular risk information with your doctor or nurse at your next appointment.

Once you’ve answered all the questions, click the SAVE RESPONSES button below to save a copy of the information sheet related to your answers. You may wish to discuss this cardiovascular risk information with your doctor or nurse at your next appointment.

For iOS devices, after you’ve clicked on SAVE RESPONSES, press down on the information sheet and click SAVE IMAGE
For Android devices, after you’ve clicked on SAVE RESPONSES, click DOWNLOAD to save the information sheet to your mobile device

Download PDF Save Responses

This information was taken from diabetes.org.uk, nhs.uk and nice.org.uk.


UK/CC/0818/0031a November 2018

Why is it important to know about cardiovascular disease?

Consensus report