Many people are aware of the strong link between type 2 diabetes and heart disease. Maybe you have one or both conditions, or know someone who does.

It’s important to know about this link if you have diabetes.

Adults with diabetes are two to four times more likely to die from heart disease than those without diabetes. But there are ways to lower your risk.

When multiple risk factors for type 2 diabetes and heart disease occur in the same person, it’s called metabolic syndrome.

Read on to learn more about the connection between these conditions — and some of the steps you can take to manage the risk.

Metabolic syndrome occurs when someone has multiple risk factors for type 2 diabetes and heart disease. It includes having three or more of the following:

  • High blood sugar. High blood sugar occurs when your body doesn’t have enough insulin or doesn’t use insulin properly. When your body doesn’t use insulin properly, it’s known as insulin resistance.
  • High blood pressure. When your blood pressure is high, your heart has to work harder to pump blood around your body. This puts strain on your heart and can damage your blood vessels.
  • High triglyceride levels. Triglycerides are a form of fat that provide a stored source of energy for your body. When triglycerides levels are high, it can cause plaque to build up in your arteries.
  • Low HDL (good) cholesterol. HDL helps clear out LDL (bad) cholesterol from your blood vessels.
  • Excess belly fat. Carrying too much fat in your abdomen is linked to increased risk of insulin resistance, high blood sugar, high blood pressure, high triglycerides, and low HDL.

People with type 2 diabetes have insulin resistance, which stops their body from using sugar properly. This leads to high blood sugar.

Insulin resistance and high blood sugar can affect your heart, blood vessels, and fat levels in several ways. This can raise your risk for heart disease.

Over time, high blood sugar levels can cause damage to your body. Your heart and blood vessels are some of the areas that can be affected.

For example, high blood sugar can:

  • Create more work for your heart. When there’s a high amount of sugar in your blood, it takes more work for your heart to pump it.
  • Increase inflammation in your blood vessels. Inflammation in your arteries results in increased cholesterol buildup and artery hardening.
  • Damage small nerves in your heart. Nerve damage in your heart disrupts normal blood flow.

According to the American Diabetes Association, 2 out of 3 people with diabetes also have high blood pressure or take medication to reduce their blood pressure.

Insulin resistance in people with type 2 diabetes may help explain why.

Insulin resistance can narrow your blood vessels, making your blood pressure higher. It can also cause your body to hold on to salt, which can raise blood pressure as well.

Insulin resistance and high blood pressure can both damage blood vessels, creating more work for your heart.

Insulin resistance and high blood sugar can contribute to:

  • Higher triglyceride levels. Typically, the body uses insulin to move sugar from blood into cells, where it’s used for energy or stored as glycogen. When you have insulin resistance, your body converts more sugar into triglycerides instead.
  • Lower HDL levels. Your body uses HDL to clear out excess triglycerides, which reduces your HDL levels. Excess blood sugar can also attach to HDL and cause it to break down more quickly than usual, lowering your HDL level.
  • Higher VLDL levels. Very low-density lipoprotein (VLDL) is a type of bad cholesterol. It’s made of smaller particles than LDL. When your triglyceride levels are high, more VLDL is created.

When HDL is busy clearing out excess triglycerides, there’s less HDL available to clear out cholesterol from your blood vessels.

The longer they stick around in your blood vessels, the more time triglycerides, LDL, and VLDL have to stick to your artery walls. This causes your arteries to narrow and harden, which means your heart has to work harder to pump blood through your body.

To reduce your risk for heart disease, it’s important to:

  • Eat a well-balanced diet. A Mediterranean diet may have benefits for heart health. This diet is rich in fruits, vegetables, whole grains, beans, nuts, seeds, and healthy fats.
  • Get regular physical activity. Reducing sedentary time and getting more exercise may help reduce your blood pressure, cholesterol, and abdominal fat.
  • Find ways to manage stress. High levels of stress hormones can increase your blood pressure, blood pressure, and body fat levels.
  • Get enough quality sleep. This may help prevent high blood pressure and high blood sugar. It’s also important for your overall well-being and energy levels.
  • Take your prescribed medications. Your doctor may prescribe medications to help manage your blood sugar, blood pressure, and cholesterol levels.

In some cases, your doctor may recommend other treatments or lifestyle changes to help manage type 2 diabetes and reduce your risk for heart issues.

Several risk factors for heart disease are more likely to occur in people with type 2 diabetes.

However, there are steps you can take to lower your risk for heart complications. Eating a healthy diet, staying active, managing stress, getting enough sleep, and taking your recommended medications can help.

Your doctors, nurses, dietitians, and other healthcare providers can help you learn how to make lifestyle changes and get the treatment you need to protect your heart health.