Diabetes brings with it plenty of possible complications, including heart disease. You are at least twice as likely to have heart disease or a stroke as people who don’t have diabetes, according to WebMD.

It's important to stay informed on the latest recommendations so you are prepared to tackle this complication of diabetes effectively with the help of your doctor. Even though diabetes increases your risk, heart disease can often be kept at bay if you know what to do.

Risk factors

Diabetes itself is a risk factor for heart disease and stroke, according to the National Institute of Diabetes and Digestive and Kidney Diseases. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. The World Heart Federation says that hypertension, abnormal blood lipids, and obesity occur more frequently in people with diabetes.

Other risk factors include:

• Central obesity (extra weight around the waist)
• Abnormal cholesterol
• High blood pressure
• Smoking

Additionally, poorly controlled diabetes can damage blood vessels and lead to plaque buildup. Research suggests any amount of coronary plaque may affect mortality and heart disease in those with diabetes, according to Diabetes in Control.

Dr. Philipp Blanke and his colleagues found mortality risk doubled in the presence of mild or obstructive stenosis—that is, even if someone with diabetes had only mild arterial plaque buildup and no symptoms to speak of, his or her risk of death would still double. This could be very dangerous, as without consistent monitoring it is possible to miss this condition until it manifests—and then it can be deadly.

"A lot of patients end up having their first symptom as a heart attack or even death," Dr. J. Brent Muhlestein, from the University of Utah, cautioned. "We would like to be able to identify those patients and treat them before they die or have a heart attack."

The researchers recommend aggressive medical management of people who have high cardiovascular risks and diabetes—which may include all people with diabetes. Indeed, management of this kind reduced adverse events in all study participants who were diabetic.

Avoid the risks

Recommendations from the American Diabetes Association regarding cardiac care for people with diabetes suggest you should take statins to manage the cardiovascular risks, according to Consultant Live. This is because you're already at high risk of heart disease.

Under the recently revised guidelines, you should also exercise regularly, never remain stationary for more than 90 minutes, and undertake resistance training twice a week.

"The big change here is to recommend starting either moderate- or high-intensity statins based on the patient's risk profile rather than on LDL level," Dr. Richard W. Grant, chair of the Professional Practice Committee, told Consultant Live. "Since all patients with diabetes are at increased risk, it is just a matter of deciding whom to start on moderate- versus high-intensity statin doses."

You should also follow the “ABCs of diabetes.” This means monitoring your A1c, blood pressure, and cholesterol. When assessing your overall health, check out the following numbers as a starting point for comparison. These are the ideal numbers for most adults, according to The American Heart Association:

• Total cholesterol less than 180 mg/dL
• Blood pressure less than 120/80 mm Hg
• Fasting blood sugar less than 100 mg/dL
Body mass index less than 25 kg/m^2

Focus on modifiable lifestyle factors such as diet, exercise, and not smoking. Reduce consumption of high-fat and cholesterol-laden foods such as fried foods, red meats, and eggs, and eat more high-fiber foods, including whole grains, vegetables, and fruits, suggests Everyday Health.

Your doctor may also suggest taking a low dose daily aspirin as a way to combat heart disease. If you are overweight, work with a registered dietitian to come up with a healthy and balanced meal plan to help you lose weight.

In the end, some factors are out of your control, such as family history of heart disease, but much of what happens to your heart when you have diabetes is well within your power to manage if you are willing to make the necessary changes.