Understanding Heart Disease, Diabetes, Blood Sugar, and Insulin

When you see your doctor at your annual exam, he or she will focus on heart disease and diabetes prevention. These diseases are two of the top ten leading causes of death in the United States. While many people understand the seriousness of these diseases, few understand the link between heart disease, diabetes, blood sugar, and insulin. Understanding how these four things are interrelated will help you make choices to support a healthy heart and stabilize insulin levels.

In 2017, 4.6% of adults in South Carolina had heart disease. In the same year, 13% of adults living in South Carolina had diabetes. Both of these statistics were higher than the national average. These statistics show us how common heart disease and diabetes are and how important it is to prevent them. 

To understand how heart disease and diabetes are related, first we need to understand the relationship between blood sugar and insulin. All cells in our body need energy. Cells get this energy from sugar (glucose) in the food we eat. As the sugar in our blood increases, it alerts the pancreas to release insulin. The insulin escorts the sugar into the cells to use for energy. Too much sugar and too much insulin can cause the cells to become resistant to insulin, and the cells will not allow sugar to enter the cells. The body then sends the excess sugar to be stored in other parts of the body for later use—usually in the belly and liver.

The excess sugar in the blood attaches to proteins, which changes their structure and makes them stiff and sticky. These sticky proteins are called aging proteins or AGEs (advanced glycation end products). AGEs become sludge in the body’s tissues. This sludge prevents growth and repair of body tissues. The accumulation of AGE sludge is called glycation. One common place where glycation occurs is in the linings of arteries, which causes heart disease. Here we see how heart disease and diabetes are related: they are both caused by high blood sugar. In diabetes, high blood sugar causes insulin resistance. In heart disease, high blood sugar causes glycation in arteries.

Most people associate heart disease with high cholesterol, but many people are not aware that high blood sugar is a cause of heart disease. According to the South Carolina Department of Health and Environmental Control, two-thirds of people with diabetes (high blood sugar) die of heart disease or stroke. To decrease your risk of heart disease and diabetes, lower your stress levels, stay lean, exercise regularly, and change your diet to stabilize insulin levels. Eating complex carbohydrates that are naturally combined with protein, fat, or fiber can help stabilize blood sugar and insulin levels.


Centers for Disease Control and Prevention. (2017). Leading causes of death[Data file]. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Sears, W. (2010). Prime-time health: A scientifically proven plan for feeling young and living longer. New York, NY: Little, Brown and Company.*

South Carolina Department of Health and Environmental Control. (2014). State of the heart: Heart disease in South Carolina[Data file]. Retrieved from https://dc.statelibrary.sc.gov/bitstream/handle/10827/19510/DHEC_State_of_the_Heart_2015-07.pdf?sequence=1&isAllowed=y

United Health Foundation. (2017). Diabetes in South Carolina in 2017[Data file]. Retrieved from https://www.americashealthrankings.org/explore/annual/measure/Diabetes/state/SC

United Health Foundation. (2017). Heart disease in South Carolina in 2017[Data file]. Retrieved from https://www.americashealthrankings.org/explore/annual/measure/CHD/state/SC

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