Blood vessel blockage in the heart (ischaemic heart disease) is caused by progressive narrowing of the coronary arteries which nourish the heart muscle.

The symptoms are intermitted chest pain, generally brought on by exertion and relieved after a few minutes rest. This is due to a partial blockage of a heart or coronary artery and is called angina.

Unfortunately people with diabetes are often unaware that they have narrowed blood vessels in the heart until they block completely, causing a heart attack.

The usual symptom of a heart attack is a heavy, pressing pain across the font of the chest, sometimes going into the neck or down the left arm. Unlike the intermittent pains of angina, the pain of a heart attack may last several hours and is not relieved by rest.

Other symptoms include sweating, breathlessness, nausea, vomiting and loss of consciousness.

In people with diabetes who have nerve damage, chest pain associated with a heart attack can be absent.

Summon medical help immediately if chest pain does not disappear completely within three to five minutes. This is a medical emergency.

Provided the amount of heart muscle affected is not large, healing usually takes place and the person can return to normal activity.

Blocked or diseased heart arteries are often surgically bypassed or sometimes opened up with a balloon and kept open by insertion of round mesh of metal called a stent.