Updated February 29, 2016

Mike has diabetes but was unaware it increased his risk of heart disease.(MIKE BOSCIA)

Having diabetes is a bit like throwing gasoline on the fire, in terms of heart risk. Adults with diabetes are two to four times more likely to die of heart disease than people who do not have diabetes. In fact, at least 65% of people with diabetes die of heart disease or stroke, according to the American Heart Association.

But you may not have heard the news, particularly if you were diagnosed many years ago.

Mike Boscia of San Diego is a former helicopter assembler who has had 15 artery-clearing angioplasties, 15 stents implanted to prop open clogged arteries, and a quintuple bypass. Although he can't walk very far on his own, he tools around on a motorized scooter. Now 52, he was diagnosed with type 2 diabetes roughly 15 years ago. At the time, though, no one warned him about the risk of heart disease.

"I don't ever remember talking about that when I was first diagnosed," says Boscia, who is also being treated for high blood pressure and cholesterol.
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Most people with diabetes unaware of heart risk
If you didn't know the strong link between heart disease and diabetes, you're not alone.

Sixty-eight percent of people with diabetes don't consider heart disease to be a serious complication, according to a study published in 2002 in the Journal of the American College of Cardiology. They are much more likely to be aware of complications such as blindness (65%) and amputation (36%) than heart disease (17%), heart attack (14%), and stroke (5%).

The knowledge gap is particularly acute among certain ethnic groups. Hispanic and Latino Americans, for example, are more likely to have diabetes than non-Hispanic whites, yet only one in four Hispanic/Latinos with diabetes know they are at risk for heart disease, says the National Diabetes Education Program.

[ pagebreak ]New campaign to boost awareness
You need to maintain strict control of your blood sugar, blood pressure, and cholesterol to ward off problems. And that advice hasn't been emphasized enough, as Mike Boscia's experience illustrates.

In 2007, though, the National Diabetes Education Program began a public education campaign emphasizing the importance of controlling diabetes and cardiovascular disease.

The campaign urges people with diabetes to know their "ABCs":

  • A is for A1C: You should have this blood test, short for hemoglobin A1C, at least twice a year. It can tell you your average blood glucose for the past two to three months. The target for most people is below 7%.
  • B is for blood pressure: Have it checked every time you see the doctor. The target for most people with diabetes is below 130/80.
  • C is for cholesterol: You should have your cholesterol checked at least once a year. The targets for most people are:
    • LDL (bad) cholesterol: below 100
    • HDL (good) cholesterol: above 40 in men and above 50 in women
    • Triglycerides (another type of fat in the blood): below 150

Boscia's wife Lee was diagnosed with type 2 diabetes about three years ago, but her experience has been strikingly different. "Right away," her husband says, the doctors told her, "'We're going to keep an eye on your heart, too, because (diabetes) can affect it.'"