When November rolls around and we see ribbons, awareness posts, and campaigns dedicated to different health issues, it can be easy to scroll past them, assuming they don’t directly affect you. However, if you’re a woman living in the U.S., World Diabetes Day or the campaign for diabetes this month is very relevant to your heart, not just your blood sugar.
For women, diabetes and heart disease are often intertwined. In fact, women with diabetes are at twice the risk of developing heart disease than women without. In part, that’s because the presence of diabetes often accelerates atherosclerosis (plaque build‑up in the arteries), intensifies inflammation, and raises the likelihood of heart events that are not always recognized right away, especially in women.
Let’s walk through what this means, how women in particular face specific challenges, and what you can actually do about it.
Why the link between diabetes and heart disease is so strong
Diabetes affects how your body handles glucose, but also how your blood vessels respond to damage. In a person with diabetes, high blood sugar can injure the arteries, damage the lining of vessels, and set the stage for plaque to accumulate faster. That means the “pipes” in your heart system are at higher risk of clogging, narrowing, or losing flexibility.
For women, this risk is amplified. Studies show that women with diabetes lose the cardiovascular “advantage” that many younger women have versus men. Put simply, while pre‑menopausal women without diabetes often have a lower risk compared to men, once diabetes enters the picture, that gap closes or even reverses.
Moreover, symptoms of heart disease in women are less often the “classic” chest pain presentation, one long designed around men’s experiences. Add diabetes to the mix, and things like fatigue, shortness of breath, nausea, jaw or back pain may be dismissed as complications of diabetes rather than warning signs of heart disease. That delay in diagnosis is one reason outcomes in women may be worse.
What women should watch for
Because the intersection of diabetes and heart disease isn’t always obvious, here are some warning signs and factors to pay attention to:
- Persistent fatigue, even when the diabetes seems “under control.”
- Shortness of breath or exertional intolerance, especially if your glucose levels are stabilized.
- New or worsening swelling in legs or feet, which could signal heart failure or vascular strain.
- Symptoms of chest discomfort, including pressure, fullness, or back/jaw involvement.
- A family history of heart disease or stroke, especially if paired with high A1C, hypertension or high cholesterol.
- Lifestyle changes (diet/exercise) that don’t appear to improve outcomes; these may signal underlying cardiovascular issues rather than just glucose management.
What you can do to protect your heart
Knowledge and action can work together to protect your heart. Here are practical steps women with diabetes (or at risk) can take now:
- Ask for a cardiovascular risk assessment specifically. If you have diabetes, request that your provider evaluates your heart health, not just your glucose levels.
- Review your medication regimen with your provider. Some diabetes treatments have cardiovascular benefits; ask whether yours should.
- Monitor and optimize blood pressure and lipids. This is even more important in diabetes. A good blood pressure and cholesterol profile can reduce the additional burden on your heart.
- Keep track of symptoms, changes, and family history. Bring this list to every appointment so you don’t rely solely on brief clinic time.
- Balance lifestyle interventions with medical follow‑up. Diet, exercise and weight control matter, but they don’t replace screening or cardiovascular evaluation.
- Join a community or peer support group (such as the resources at WomenHeart) to stay informed, share stories and ensure you’re not navigating alone.
Conclusion
If you’re a woman with diabetes, or concerned about your risk, don’t treat your heart health as a secondary priority. In truth, diabetes is a heart disease risk factor. And when the system, your provider, or your symptoms don’t reflect the “usual” picture, advocacy becomes critical.
During this month of awareness, use it as a catalyst to ask the right questions, get the right tests, and make sure your heart gets the attention it deserves.
Your story matters. Your heart matters. Let’s make sure they both get heard.
