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There are two distinct forms of heart disease that are related to diabetes: The commonest one is the hardening of the arteries (the atherosclerotic process) that leads to heart attacks and can also lead even to sudden death when people collapse and die at home or even out in town. The second diabetic heart disease is less common: it’s when the diabetes affects the ability of the heart to squeeze. In other words, it decreases the heart function so that patients develop heart failure. With heart failure, people are short of breath, they develop swollen ankles, they’re fatigued, and it is also a very lethal complication of diabetes.