When someone is diagnosed with diabetes, the focus often turns to treatment – mainly how to keep blood sugar in control. What often goes unacknowledged is the fact that people with diabetes are more likely to develop cardiovascular disease and have a greater chance of having a heart attack or a stroke than people without diabetes. In this case, overall risk factor management becomes important.

The 2022 American Diabetes Association (ADA) Standards of Medical Care provide guidance related to cardiovascular disease and risk management in adults with diabetes. Recommendations include:

• Blood pressure control (including screening and diagnosis)
• Lipid and triglyceride management (including statin management)
• Blood glucose control
• Pharmacologic intervention
• Antiplatelet agents (aspirin)
• Cardiovascular disease screening and treatment
• Lifestyle interventions (weight loss, increased physical activity, smoking cessation, moderation of alcohol intake)

To address these recommendations in a worksite setting, it helps to start with integrating wellness and well-being into the culture and environment of the organization. Then a combination of individual and organizational changes/initiatives are likely to be most effective. Existing programs and benefits can be used and newly, focused interventions and modifications can be created. Targeting specific health behaviors such as smoking cessation and nutrition, screening/early detection, stress and weight management can have an impact on multiple risk factors at once. Also consider environmental modifications that support the adoption and maintenance of healthy behaviors at work. This will likely impact behaviors at home as well.