We Won’t Sugar Coat It: Diabetes and Heart Disease

Happy Leap Day! As February comes to a close, we would like to leave you with some information about another major risk factor for heart disease and stroke. We talked about salt, now let’s talk about sugar! We told you high blood pressure is the leading risk factor for heart disease and stroke, but did you know that diabetes is also an independent risk factor as well? According to the American Diabetes Association (ADA), at least 68% of people with diabetes die from heart disease. The ADA also reports that adults with diabetes are 2 to 4 times more likely to develop heart disease than those without. The sweet news is that there are steps you can take to prevent it. So let’s begin.

What is diabetes?
Diabetes is a disorder of glucose metabolism, the basic sugar molecule that carbohydrates are broken down into. Although that sounds fancy, it really just means that the body is unable to use its main energy source properly. The body needs a hormone called insulin in order to let glucose into cells and be used as energy. With diabetes there is either no insulin produced (Type 1) or the insulin that is produced is not as effective (Type 2). Between 90-95% of diabetics are classified as Type 2. This is mostly linked to physical inactivity and increased body weight, though family history plays a role as well.

How do you know if you have it?
Nearly 7 million Americans have diabetes and don’t know it. Years before diabetes is diagnosed, certain cells in the body become less responsive to insulin when obesity is present and activity level is low. At first the pancreas, the organ that produces insulin, is able to keep up, but as time goes on production slows and blood sugar levels rise above the normal range. Symptoms of high blood sugar include excessive thirst and increased urination, fatigue, weight loss, blurred vision and slow wound healing or frequent infections. Talk to your doctor about your concerns and have your blood sugar checked.

What can you do to control it?
The National Diabetes Education Program (NDEP) encourages diabetics to follow the “ABC’s”: keep your A1C less than 7%; maintain blood pressure less than 130/80 mmHg; and control cholesterol by keeping LDL levels less than 100mg/dL. The A1C is a measure of blood glucose over a 3 month period. This is important because tight control of blood sugar reduces the risk of heart attack, stroke of death from cerebrovascular disease by 57% according to the NDEP. According to the American Heart Association, high blood pressure is twice as likely in individuals with diabetes as in those without. Although for the rest of the population blood pressure should be kept less than 140/90, diabetics should be lower due to the combined effect of high blood pressure and diabetes on heart disease and stroke risk. For the majority of diabetics, keeping LDLs lower than 100mg/dL is enough, however, if you already have been diagnosed with heart disease your doctor may want your LDL to be less 70mg/dL to further lower your risk of heart attack and stroke. In addition to medication therapy, regular exercise decreases these bad fats and increases levels of good fats in your bloodstream.

Why are diabetics at such an increased risk?
Some explanations are more complicated than others. For starters, over time when blood sugar remains high, damage occurs to the inside lining of blood vessels. This damage puts the individual at a higher risk of a process called atherosclerosis, or plaque build up in arteries. Some research also points to increased inflammation in the vessels as a cause of this according to Joslin Diabetes Center. Diabetics also have greater rates of a process called platelet aggregation. Platelets are the sticky substance in your blood that allows your blood to clot when blood vessels are damaged. So although they have an important function, they cause problems when they stick to damaged artery walls and  narrow the artery where blood passes through. These processes are both worsened by and result in high blood pressure. This is the start of the vicious cycle of heart disease.

It is recommended that you reduce your risk through modest weight reduction and regular exercise. Getting 30 minutes of exercise 5 days a week is ideal, but talk to your doctor about what’s right for you. You may have to start small with 5-10 minutes of walking per day and work up to your goal if you experience shortness of breath or feel over-exerted.
If you smoke: set a quit date today! Visit our education page for resources on smoking cessation. This is the single most important step you can take to lower your risk of diabetes, heart disease and stroke.

Thank you all for checking in for this month’s blog series on heart disease. We hope you gained some insight into America’s leading cause of death and learned how you can reduce your risk. Make small changes today for a healthier tomorrow. You can do it, we believe in you!