8 Ways to Manage Type 2 Diabetes and Heart Health

Here are eight ways to manage your diabetes and improve your heart health simultaneously, and why experts believe they're beneficial for both.

Exercise can lower the risk of cardiovascular disease in people with diabetes, says Micah J. Eimer, MD, a cardiologist at Northwestern Medicine in Evanston, Illinois.

Focus primarily on aerobic exercise like walking, jogging, biking, or swimming, says Dr. Eimer. Aerobic exercise strengthens your heart, which helps it pump more efficiently and improves blood flow throughout your body. Work with your diabetes healthcare team to plan any physical activity, especially if you're new to exercise.

Eimer also recommends resistance exercises, because muscles are a major consumer of glucose (sugar) in the body. “I'm a big believer in the value of resistance training,” he says.

If you're unsure how much of various activities is best for you, your doctor may suggest meeting with a personal trainer. You may also benefit from working with an exercise physiologist who can create a personalized activity program for you, says Ann Feldman, RD, a nutrition and diabetes educator at the Joslin Diabetes Center in Boston.

Your fat and carbohydrate intake are crucial to managing both diabetes and heart disease. Feldman says you should pay attention to the types of each nutrient you consume, not just the overall amounts.

Limit your consumption of saturated fat, which is found in meat, dairy products, and some tropical oils, since it can elevate levels of unhealthy LDL cholesterol in your blood, leading to the buildup of fatty deposits called plaque in your arteries.

Also avoid refined carbohydrates, including the refined sugars and processed grains found in many snack foods and desserts. These foods can raise blood sugar levels more quickly and are associated with higher rates of heart disease, says Eimer.

As far as what you should be eating, Eimer recommends following the Mediterranean diet, which prioritizes whole grains, legumes (peas, beans, and lentils), fish, lean meats and poultry, healthy fats from olive oil and nuts, and plenty of fruits and vegetables.

Being overweight or having obesity is often complicated by metabolic factors that raise both your blood sugar and your heart disease risk, especially if you carry excess fat in certain areas of your body. “If you have a lot of abdominal body fat or visceral body fat, that's correlated with insulin resistance,” says Feldman.

Since losing weight can be difficult, Eimer prefers to emphasize healthy behaviors rather than the desired result of weight loss. “When I have a patient who is inactive and overweight, I try to get them to focus on increasing their activity,” he says. “That will usually reduce weight.” And if it doesn't, the person can still benefit from a more active lifestyle in other ways.

In addition to potentially raising your blood sugar in the short term, smoking can worsen the effects of diabetes complications, says Feldman. Your doctor can help guide you in your attempts to quit smoking, but if you have trouble quitting, you may be referred for smoking cessation.

Since there's no universal guideline for safe alcohol consumption for people with type 2 diabetes, the ADA suggests discussing personal drinking habits with your doctor for individualized advice.

When it comes to stress and heart disease, Eimer says there's clearly a relationship, although it's difficult to quantify because it's hard to measure stress.

Exercise is an effective tool for reducing stress, which Eimer mentions when he recommends physical activity to patients. Additional techniques, such as biofeedback, meditation, and psychotherapy, may also help reduce stress. Eimer says if someone is unable or unwilling to exercise more, these other methods may be worth exploring.

Unfortunately, many people are reluctant to report signs of depression because they feel that they're admitting weakness, says Feldman. “The stigma associated with behavioral health [treatment] should be lifted, and physicians should freely refer patients to behavioral health if they feel that the patients need it.” If you're navigating depression, work with your doctor to find additional healthcare providers in your insurance network who can help.

• When it comes to managing diabetes and heart problems, a healthy choice for your diabetes is often a healthy choice for your heart, too.
• Regular physical activity, including both aerobic exercise and resistance training, brings significant metabolic and cardiovascular benefits, and personal trainers and physiologists can help you design a routine that's safe and effective for you.
• The Mediterranean diet can help keep your blood sugar under control, as well as provide nutrients that are essential for heart health.
• Stop smoking, limit alcohol consumption, prioritize quality sleep, and practice stress reduction techniques to better manage diabetes and prevent heart problems.

Additional reporting by Katherine Lee.