Heart attacks and strokes in England are set to surge in the next 20 years as diabetes cases linked to lifestyle increase, a charity has warned.
The number of diabetics is projected to rise by one million by 2035, largely driven by more cases of type 2 diabetes and increasing rates of obesity.
This could lead to a 29% rise in heart attacks and strokes linked to diabetes, the British Heart Foundation said.
The charity said "bold action" was needed to tackle the obesity epidemic.
Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness and kidney failure.
The large majority of cases - 90% - are caused by type 2 diabetes, which is linked to obesity and other poor health choices.
The other 10% have type 1 diabetes, a disease of the immune system that has nothing to do with lifestyle choices, and is neither preventable nor reversible.
Public Health England predicts that if current trends continue there will be five million diabetics by 2035.
The British Heart Foundation estimates this will lead to:
- 39,000 people living with diabetes suffering a heart attack - a rise of 9,000 compared with 2015
- more than 50,000 people with the illness will have a stroke - an increase of 11,000
- there will also be more cases of other health conditions, including angina and heart failure
The increase in the number of diabetics with serious health problems is likely to put an "unprecedented burden" on the NHS, the BHF warned.
Simon Gillespie, the charity's chief executive, said: "Thanks to research, we've made excellent progress in improving survival rates for heart attacks and strokes.
"However, today's figures point to an extremely worrying trend.
"People with diabetes are at an increased risk of developing heart and circulatory diseases, and the expected surge in type 2 diabetes cases by 2035 could put thousands more people at risk of a deadly heart attack or stroke."
Sarah Miles suffered a heart attack when she was just 38, shortly after being diagnosed with type 2 diabetes.
She said her heart attack, and subsequent cardiac arrest, forced her to give up her nursing career.
Sarah, 43, from Somerset, said: "Living with diabetes is difficult, but to then have a heart attack was a total shock.
"The attack led to heart failure, which has severely limited my quality of life.
"I've had to give up my nursing career, my social life, and my family dynamic has totally changed forever."
The warning by the BHF follows the release of figures last week showing a rise in the number of children and young people being treated for type 2 diabetes in England and Wales.
The number rose from 507 to 715 in four years, the data revealed.
More than three-quarters of these children and young people were also obese, according to the NHS figures.
Mr Gillespie said "bold action" was needed to tackle obesity and inactivity, "especially among young people".
He added: "This must include consideration of further regulatory action to reduce sugar and fat content in food, and to curb junk food advertising directed at young children.
"The food industry is not acting quickly enough to re-formulate its products, despite mounting evidence of their impact on the nation's health."