Angina and diabetes: what you should know

Angina happens when part of the heart muscle does not receive enough oxygen-rich blood. In someone with diabetes, it may feel like pressure or tightness, but it may also appear as breathlessness, unusual fatigue, nausea, sweating, or discomfort in the arm, jaw, back, or upper abdomen.

Persistently high blood glucose can damage blood vessels and is often present alongside high blood pressure or unhealthy cholesterol levels. These factors can narrow the coronary arteries that supply the heart. Diabetes can also affect nerves, so reduced blood flow may cause milder pain or symptoms that are easy to mistake for indigestion or tiredness.

A new symptom pattern deserves assessment even if it does not resemble classic chest pain. An electrocardiogram can record the heart's electrical activity, although a clinician may need other tests because an ECG can be normal between episodes.

Follow the angina action plan given by your clinician and take prescribed medicines as directed. Keep a note of what you were doing, the symptoms, how long they lasted, and whether rest or prescribed angina medicine helped. Check glucose as instructed, especially during illness or after a change in activity.

Regular reviews should cover blood pressure, cholesterol, glucose control, kidney health, smoking, activity, food choices, and medicine side effects. Do not stop heart or diabetes medicines because symptoms improve; speak with the prescriber if dizziness, low glucose, swelling, muscle symptoms, or other problems develop.

Call emergency services for chest pressure, tightness, or discomfort that is new, severe, occurs at rest, lasts longer than expected, or does not settle according to your prescribed angina plan. Seek emergency help as well for fainting, marked breathlessness, a cold sweat, confusion, or discomfort spreading to the arm, jaw, back, or upper abdomen. Do not drive yourself.

Arrange prompt clinical review if episodes are becoming more frequent, happen with less activity, wake you from sleep, or feel different from your usual angina. The change in pattern matters even when the discomfort is mild.

Ask which symptoms should trigger your emergency plan, how to use any prescribed medicine during an episode, and whether your current glucose, blood pressure, and cholesterol targets suit your health. Also ask whether exercise needs adjustment and which tests are appropriate if your symptoms are atypical.