If you are living with heart disease, know that you are not alone. Over 30 million Americans have been diagnosed with some form of heart disease.

That is just over 12% of the adult population. 

And if you are also living with type 1 diabetes, you have even more company.

About 40% of T1Ds have cardiovascular disease (CVD) by the age of 60, with women being at the greatest risk for developing it at an early age.

Despite these grim statistics, if you are a woman living with type 1 and heart disease, there are still a number of things you can do to reduce the amount of damage being done to your heart and possibly even reverse the damage that is already there.

Aim for Fewer Hyperglycemic Episodes

When it comes to managing diabetes for long term health, there is one thing we have always been taught: Keep your sugars down. While hypoglycemia can cause quick, life-threatening emergencies, the damage done by hyperglycemia is often slow to show itself.

But, rest assured, the damage is being done.

It’s not just your kidneys, eyes, and nerves that suffer from this damage either. Your vascular system and your heart, in particular, carry the brunt of this destruction. 

When your blood sugar is high, it causes your vessels to constrict, forcing your heart to work harder and increasing the odds that blockages will form. Hyperglycemic nerve damage also has a negative effect on how well your heart functions.

If you are already suffering from heart disease, you can reduce future damage to your heart and vessels by working hard to keep your blood sugars from spiking. This means working closely with your doctor to build an intensive treatment plan aimed at keeping your sugars low and reducing your A1C to well below the recommended 7%.

Increase Your Time in Range

For decades, doctors believed that hyperglycemia was one of the biggest contributors to diabetic heart disease, but more recent research has found the story to be more complicated.

Many types of heart diseases seem to be present in those living with diabetes regardless of their A1C. This is especially true of coronary heart disease. One reason behind this phenomenon has to do with the oxidative damage that occurs during blood sugar swings.

Studies have shown that widely varying blood sugars can cause just as much damage to vascular tissue as consistently high blood sugars. This damage is due to an oxidative stress response that occurs when blood sugar changes too rapidly.

For this reason, getting your A1C down into the healthy range may not be enough to prevent future heart damage. Instead of focusing just on that number, it is also important to focus on the amount of time you spend in range. 

Someone who is swinging wildly between 50 mmol/l and 250 mmol/l may show an average BG of 130 mmol/l, but they are still suffering a lot of oxidative damage. 

In contrast, if you focus on bringing your time-in-range up (your time between 70 mmol/l and 180 mmol/l) you’ll suffer less damage from both oxidation stress and from hyperglycemia.

Commit to a Lipid-Reducing Lifestyle

Of course, diabetes isn’t the only thing contributing to your heart damage. To really get control of your health and reduce or reverse your CVD, you have to make changes to your lifestyle as well.

Stay Active

Exercise has long been touted as one of the best ways to decrease your risk of heart disease, but getting active can be equally effective at fighting heart disease.

When you have artery blockages, less blood than normal is delivered to parts of your heart. This oxygen and nutrient deprivation can lead to more severe complications. Ironically, though, one way to avoid some of these complications is to increase that blood deprivation during exercise.

According to cardiologist Dr. Meagan Wasfy, when areas of the heart are starved of blood during short bouts of exercise, those areas develop adaptations to deal with that deprivation. Once you finish exercising, your heart will be better equipped to deal with the less intense blood flow decrease caused by blockages.

Beyond getting your heart used to a low oxygen environment, exercise can help you lose weight and normalize your blood lipid levels.

This is important even if you are not overweight. The most damaging type of fat, when it comes to heart disease, exists around your waist. For women, this fat is often present even if you have a normal BMI. To reduce the effects of heart disease, most women should aim for a waist size of 35 inches or less.

Eat Well

While exercise can help prevent future heart damage, it can’t typically reverse the condition on its own. For that, you are going to need to commit to an even more drastic lifestyle change.

One of the only doctors to show consistent success in reversing heart disease is an MD named Dean Ornish. 

For five years in the late 1980s, he subjected one group of heart disease patients to intense lifestyle modification while the other group underwent traditional heart care. While the intensive care group received a variety of lifestyle modifications, including increased aerobic exercise, stress management, and group peer support, the biggest change they were forced to undergo was switching to a whole-food, vegetarian diet made up of only 10% fat.

After five years, those patients on the intensive care regimen had an average percent diameter stenosis decrease of 3.1% while the control group’s arteries showed increased stenosis of 11%, for a 27.7% relative worsening condition. So while those on the low-fat vegetarian diet saw a reversal in artery blockage, those on the traditional treatment actually suffered more severely clogged arteries.

While many doctors and hospitals are still hesitant to recommend such a strict diet change to their patients, Dr. Ornish’s vegetarian diet method remains one of the only programs that have successfully reversed heart disease.

It is hard to say if this diet and exercise regimen would have the same effect on a woman living with type 1, but it would certainly be worth exploring further for anyone serious about taking back control of their heart health.

Take the Necessary Medications

Of course, one of the hallmarks of traditional heart disease treatment is the use of medications to control blood pressure, cholesterol, and to thin the blood. While your goal should be to get to a point where you no longer need these meds, that doesn’t mean you should avoid them altogether.

In general, women are undertreated for all sorts of conditions, with diabetes and heart disease being at the top of the list. That’s why it is so important to talk to your doctor to obtain and use the right medications and treatments to protect your health.

It is time to find a new doctor if you ever feel like you are being ignored, your concerns aren’t being taken seriously, or you aren’t being treated as intensely as your male counterparts.

Know That It Isn’t Too Late

Having two chronic and, oftentimes, debilitating conditions can make it seem like a bright future is impossible. But that doesn’t have to be the case.

Even for women with diabetes, who seem so unfairly targeted by heart disease, there is hope. With dedicated blood sugar management, consistent exercise, an intensive diet change, and the support of the right doctor, it is possible to protect your heart and live a full life.