How diabetes affects your heart: Insights from Dr. Lindsey Mitrani

Dr. Lindsey Mitrani is a heart doctor (cardiologist) with Optum Medical Care in Mount Kisco, NY. In honor of Diabetes Awareness month, Dr. Mitrani recently sat down with us to talk about how diabetes can affect your heart—and what you can do to stay healthy.

Q: What does “comorbidity” mean?

Dr. Mitrani: A comorbidity is when a person has two or more diseases at the same time¹ For example, a person may have both diabetes and heart disease. Diabetes can also raise your risk of heart disease². Other risks include high blood pressure, high cholesterol, being overweight, smoking, and family history³.

The good news? Diabetes is a modifiable risk—which means we can help control it with healthy habits and medicine⁴.

Q: Can diabetes really affect your heart?

Dr. Mitrani: Yes! People with diabetes have twice the risk of heart problems⁵. That includes heart attacks, heart failure, stroke, and even poor blood flow in the legs.

Even though diabetes is about blood sugar, it can cause plaque to build up in your arteries, which can lead to serious heart issues⁵.

Q: What signs should people with diabetes watch for?

Dr. Mitrani: People with diabetes should look out for the same signs of cardiovascular disease as anyone, including⁴ :

• Chest pain or pressure felt in the arms, shoulders, neck or jaw
• Shortness of breath
• Feeling more tired than usual or weak
• Decreased exercise tolerance
• Fast or irregular heart rate
• Episodes of light-headedness
• Swelling or sudden weight gain (from fluid)

But here’s something important: some people with diabetes don’t feel any symptoms at all. That’s called a silent heart attack (also known as Silent Ischemia) and people with diabetes are at an increased risk of developing silent ischemia⁶ . So even if you feel okay, it’s smart to talk to your primary care doctor to see if a visit to a cardiologist is right for you.

Q: What can patients do to protect their heart?

Dr. Mitrani: We work as a team—cardiologists, primary care doctors, and endocrinologists. The number one thing for diabetes is to control the risk factors we can control. Together, we help you:

• Control your blood sugar (A1C)
• Manage blood pressure and cholesterol through diet or medications
• Determine if you need any heart tests like stress tests (a test to see if you have blockages in your heart) or an echocardiogram (an ultrasound to see the function of your heart)

Studies show that if we can get these risk factors under control, we can lower your risk of heart disease and catch problems early⁴. So, an ounce of prevention is worth it.

Q: If a patient needs to see a cardiologist, are they able to get all the tests needed with you?

Dr. Mitrani: Absolutely. At Optum, we can take care of all our patients’ cardiac testing needs. A cardiologist would first do a comprehensive risk assessment looking at blood pressure, cholesterol, and any past imaging they may have had such as CT scans to see if they have evidence of plaque or cholesterol deposits. We will also look at their EKG (an Electrocardiogram, a test that measures electrical heart activity or rhythm)⁷, and identify how we can control any of these risk factors. If we need more testing, we may order an echocardiogram or a stress test based on the individual needs of that specific patient.

 Q: What would you say to someone with diabetes who’s nervous about seeing a heart doctor?

 Dr. Mitrani: I’d say: I’m here to help. Let’s work together to prevent heart attacks and heart failure. We’ll talk not just about medications but about your lifestyle, your goals, what diet modifications you can make, and what works best for you. The most important thing is the patient; and everything we do is personalized for you.

Takeaway:
If you have diabetes, it’s important to remember that it can affect your heart’s health. People with diabetes may not experience the expected symptoms of a heart attack, so it’s important to work with your primary care provider about getting a complete risk assessment. Even if you feel fine, getting a heart checkup is good for your health. Talk to your doctor or an Optum cardiologist to learn more.

Sources:

1. Cleveland Clinic. Comorbidities. Last updated March 15, 2024. Accessed October 3, 2025.
2. American Heart Association. Diabetes Complications and Risks. Last updated April 3, 2024. Accessed October 3, 2025.
3. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, Heart Disease, & Stroke. Last updated April 2021. Accessed October 3, 2025.
4. American Diabetes Association. Cardiovascular Disease. Last updated 2024. Accessed October 3, 2025.
5. American Diabetes Association. How Diabetes Can Affect Your Heart. Last updated 2024. Accessed October 3, 2025.
6. 6 Go Red for Women. Silent Ischemia and Ischemic Heart Disease. Last updated December 11, 2024. Accessed October 3, 2025.
7. American Heart Association. Heart Health Tests for Diabetes Patients. Last updated April 4, 2024. Accessed October 3, 2025.