How to manage your health when you are living with diabetes and congestive heart failure

If you’ve been diagnosed with both diabetes and congestive heart failure, it can feel overwhelming. One chronic condition is tough — now two? There is a silver lining here: You aren’t alone. Many people have this combination of conditions. And that means experts have developed ways to help manage both. 

According to the American Heart Association and the Heart Failure Society of America, more than 40% of people hospitalized with heart failure also have type 2 diabetes. And people who have diabetes have a four times higher chance of developing heart failure than those without diabetes. 

They're separate diseases, but are closely related and affect each other. Because of this, the American Heart Association suggests approaching care cohesively with your doctor and other members of your care team.  

Doing this may help streamline your treatment and help boost your quality of life. Consider these four expert tips for managing both conditions in a way that feels right for you.  

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1. Set meaningful goals 

Dealing with diabetes and heart failure on a daily basis may seem like enough of a goal. But it’s helpful to think about what else you’d like to do, advises S. Michelle Ogunwole, M.D., a specialist in internal medicine and a research fellow at the Johns Hopkins University School of Medicine. 

“As doctors, we need to know what’s important to you and what would represent a meaningful goal for you,” she says. 

These goals don’t have to be huge items like running a marathon or losing 100 pounds. They should be smaller milestones, ones that give you a sense of progress and accomplishment, says Dr. Ogunwole. 

For example, both heart failure and diabetes can cause fatigue. So, a longer-term goal might be to walk every day without feeling exhausted. Or to sleep better so you wake up refreshed. 

Recommended reading: How diabetes affects your body from head to toe

2. Review your medications 

Multiple chronic conditions often means multiple medications. It’s a good idea to review what you’re taking with both your cardiologist and your endocrinologist. There may be medications that can help both diseases at once. 

For instance, there is now a class of medications known as SGLT2 inhibitors. They have been shown to help both glucose control as well as heart failure, according to Mansur Shomali, M.D., an endocrinologist and co-author of The Complete Diabetes Guide. 

“There are over 100 different medications that can be used to treat people with type 2 diabetes,” says Dr. Shomali. “SGLT2 inhibitors are a group of medications that have been proven to reduce blood glucose and A1C in people with type 2 diabetes. Clinicians are excited because they have also been shown to have important benefits other than just lowering glucose, such as addressing heart disease.” 

Talk to your doctor to see if these medications are appropriate for you. If they work well, you may be able to simplify your drug regimen. Make sure to keep both your cardiologist and endocrinologist in the loop.

Recommended reading: 8 questions to ask your diabetes care manager

Looking for a specialist? Use our Find a Doctor tool to locate one near you.

3. Consider your plate 

Talking to your doctors about life goals and medications is essential. But nutrition matters too. What you eat and drink can have a big impact on both diabetes and heart disease. 

“When a person with diabetes develops heart failure, a low-salt diet is more critical than ever,” says Karen Graham, R.D., a certified diabetes educator and co-author of Diabetes Meals for Good Health. “Together with medications and other treatments, a low-salt diet can help reduce fluid buildup around your heart, lungs, feet, and lower legs.” 

Here are four of Graham’s top tips to reduce sodium: 

• Keep portions small. Less food means less sodium, according to the U.S. Food and Drug Administration (FDA). Eat smaller portions when cooking at home, and split meals with a friend or take half home when eating out. 
   
• Eat more homemade foods. This way, you’ll eat fewer processed foods — the kinds that are manufactured, packaged, or premade at the grocery store. You’ll also cut down on restaurant foods. Both these contribute the most sodium to people’s diets. 
   
• Use less salt and salty seasonings. This applies to both cooking and what you have on the table to sprinkle over food. Instead, add flavor with herbs, spices, lemon, or lime. 
   
• Rinse and drain canned salted foods. This includes things like canned beans, fish, and corn. Rinsing can reduce some of the added salt. Or choose no-salt options when possible. 
   
• Read food labels. Ask your doctor what your daily sodium intake should be. (For good general health, 2,300 mg per day is the limit.) Then, use food labels to help guide your choices. 

Recommended reading: 8 myths about food and diabetes

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4. Focus on a healthy lifestyle  

“Lifestyle changes are helpful not only for your conditions, but also for your emotional well-being, and that’s crucial for quality of life,” says Dr. Ogunwole. “Especially as you age, dealing with multiple conditions can make you feel down because it can be a struggle. But finding safe, meaningful ways to connect with others and to care for yourself can have a big impact on your health.” 

Beyond dietary tweaks, there are many lifestyle changes that can greatly affect diabetes and heart failure. They include getting enough sleep, resting when you need it, not smoking, having plenty of social interaction, and finding a sense of purpose. 

Exercise is also important. But consult with your doctors first about what would be safe and effective. Simply starting with a few minutes of walking every day can help you get into the habit, notes Dr. Ogunwole. 

Another reason walking is a great workout? You can increase it in a slow but steady way. It’s also an opportunity to boost your social connections. Ask a friend or family member to join. Socializing while being active can make it more fun. 

The bottom line: Having two chronic conditions can be tough. Because diabetes and heart failure are linked, managing them together can help streamline your treatment. The more you can do this, the better you can get a handle on both — and get back to living your life. 

See our sources:
Type 2 diabetes mellitus and heart failure: Circulation  
Newer therapies for type 2 diabetes and heart disease: American Heart Association 
Understanding type 2 diabetes: American Diabetes Association 
Heart failure signs and symptoms: American Heart Association 
Diabetes and your diet: American Heart Association 
Heart failure: MedlinePlus 

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