Insulin resistance is a major culprit with both heart disease and diabetes.

Karen Barefoot

Q. I've heard about a connection between diabetes and heart disease, but I don't understand how that works. Diabetes is about blood sugar, while heart disease is about high blood pressure and cholesterol, right?

A. Diabetes is more than just blood glucose control, and heart disease is more than just blood pressure and cholesterol control. What both diseases have in common is insulin resistance.

Insulin resistance increases the chances of developing type 2 diabetes and heart disease. With insulin resistance, the cells resist insulin's commands. Glucose cannot enter into the cells, and blood glucose levels increase. With insulin resistance, blood fat levels such as triglycerides are often high, the good fat level -- HDL cholesterol -- is low, and blood pressure is above desired levels.

Unfortunately, there is no easy test to diagnose insulin resistance, and people with insulin resistance usually have no symptoms; it usually starts before type 2 diabetes and heart disease are diagnosed. Insulin resistance is improved by cutting calories, being physically active, and losing weight if you need to.

The bottom line is to talk to your health care team about ways you can control your blood glucose, blood fats, and blood pressure. Achieving goals for each involves meal planning, physical activity, and medications.

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