• Diabetes and Diagnosing Cardiovascular Disease



    If you have diabetes, your primary care physician may already have talked with you about the importance of taking care of your heart and blood vessels. If not, you should bring up the topic and ask your doctor to evaluate how high your risk for cardiovascular disease is and what you should do to prevent a heart attack, stroke or peripheral artery disease (PAD).


    These tests may include:

    • Cholesterol, including total, HDL and LDL cholesterol
    • Triglycerides, a kind of fat often elevated in people with diabetes
    • Hemoglobin A1C, which measures average blood glucose levels over time
    • High-sensitivity C-reactive protein (CRP), which measures inflammation in your body and blood vessels

    Diagnostic tests

    These tests may include:

    • An electrocardiogram (ECG or EKG), which records the electrical activity in your heart and can detect abnormalities that suggest the heart may not be getting enough blood flow in certain areas
    • Coronary artery calcium scoring, which is performed as part of a CT scanand helps your doctor determine your risk for developing serious heart disease by measuring the amount of calcified plaque in your arteries

    further tests

    This further testing may include:

    • Stress testing, which evaluates how much blood flow is getting to the heart and how effectively the heart is pumping during exercise or another type of physical stress
    • Echocardiography, which uses ultrasound to evaluate how well the heart is pumping and whether the heart muscle has become abnormally thick as a result of high blood pressure
    Coronary angiography, which involves threading a slender, flexible tube into the arteries of your heart and injecting x-ray dye to enable an interventional cardiologist to see inside your arteries, find any plaques and measure how severe they are

    Plaquer test

    Testing for plaque may include: 

    • Ultrasound, which uses sound waves to evaluate blood flow through the arteries
    • Noninvasive angiography, using computed tomography (CT) or magnetic resonance imaging (MRI) to create detailed images of the arteries without placing any instruments or tubes into the body
    • Conventional angiography, which is similar to coronary angiography but involves arteries that supply blood to organs other than the heart
    The ankle-brachial index (ABI) is also very helpful in diagnosing PAD in the legs and determining how severe it is. During an ABI test, your doctor will use a blood pressurecuff and a special ultrasound probe to compare blood pressure readings in the arm and lower leg on the same side of the body. If the blood pressure in the ankle is substantially lower than in the arm, it is a sign that a blockage is interfering with blood flow to the lower leg. The ABI provides important information for predicting the likelihood of serious problems such as foot wounds that won't heal or the need for surgery to restore blood flow to a limb.