Diabetes and Your Heart
Keep your blood glucose, blood pressure and cholesterol as close to normal as possible to protect your heart
Having diabetes is hard on your heart. You might worry more about other diabetes complications, like eye, kidney and nerve disease, but did you know that when you have diabetes there is a 65 percent chance you will die of heart disease? It's true; compared to a person who doesn't have diabetes, you are much more likely to have a heart attack, and heart problems are likely to be more severe and to strike you when you are younger.
Heart disease is also tremendously expensive to treat. As a result of the devastating human and economic toll, the medical community is paying much more attention to the diabetes–heart health connection. Scientists are trying to understand it better, and health care providers are trying to do something about it.
Diabetes and heart disease: what's the link?
People with diabetes often have all three of the major risk factors for heart disease:
- high blood glucose
- high blood pressure
- high cholesterol levels
Each of these conditions contributes to blood vessel damage; the vessels get blocked and less flexible, cutting off circulation to the heart and making it work too hard. This condition is called cardiovascular disease or CVD for short. People with diabetes are likely to suffer from other large blood vessel conditions, such as stroke, as well.
Be smart about your heart
Keeping your blood glucose, blood pressure and blood fat (cholesterol) levels as close to normal as possible can help keep your blood vessels healthy and protect your heart. Unfortunately, most people with diabetes don't know that. Most aren't aware that heart disease is the most deadly complication of diabetes, and very few know the specific things they can do to maintain heart health.
A coalition of diabetes groups including the National Institutes of Health and the American Diabetes Association launched a project to give people with diabetes and their health care providers the information they need. This project is called, “Be Smart About Your Heart: Control the ABCs of Diabetes.” The message is clear: Take control of the ABCs of diabetes care and live a long and healthy life.
A is for A1c. The A1c (A-one-c) test – short for hemoglobin A1c – measures your average blood glucose over the last three months.
B is for blood pressure. High blood pressure makes your heart work too hard.
C is for cholesterol. Bad cholesterol or LDL cholesterol builds up and clogs your arteries.
Do you know your ABC numbers? If you don't, be sure to get them from your health care provider. The American Diabetes Association (ADA) suggests the following targets: A1c below 7 percent; blood pressure below 130/80, and LDL cholesterol below 100 (The ADA recommends that people who have both diabetes and heart disease aim for an LDL cholesterol level below 70, using statin medications to reach this target). If any of your ABC numbers are higher than these targets, talk to your health care provider about actions you can take to reach your ABC targets. These actions could include changing your diet, getting more active, quitting smoking or taking medication.
Bottom line: anything you do to get closer to your ABC targets helps keep your heart healthy. For more on the “Be Smart About Your Heart” program, and lots of other useful diabetes information, visit the National Diabetes Education Project website at www.ndep.nih.gov or call 1 800 438-5383.
Look AHEAD: What does weight have to do with it?
We know that losing weight has many short-term benefits, but we don't know whether these benefits last for many years. A research study called Look AHEAD: Action for Health in Diabetes is the first to look at the long-term health effects of weight loss in men and women who are overweight and have Type 2 diabetes. Look AHEAD is principally sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. About 5,000 people between 45 and 75 years old who have Type 2 diabetes and are overweight are participating in 16 cities nationwide.
Half the participants will receive a program of diabetes support and education in a group context. The other half will receive a long-term lifestyle change program for weight loss and weight maintenance.
Part of what makes Look AHEAD unique is that it offers long-term support and follow-up. This benefits the participants and helps answer important research questions. People who have joined Look AHEAD are asked to participate for up to 11 years – four for the active intervention (weight loss or support and education) – and up to seven more years for checkup visits. This is a long commitment, but it takes at least that long to know for sure if the weight loss intervention was effective in protecting people from heart attacks and strokes.
I'm involved in this study at the Johns Hopkins University School of Medicine in Baltimore, so I wanted to tell you a little about it. Although the Look AHEAD study is closed to new participants, I hope you find other ways to be smart about your heart. To live a long and healthy life, remember your ABCs.
