Healthy You Article – February 13, 2009

Diabetes and Heart Disease
By Mary Perkins – Wellness Center Manager

Do you have diabetes?
Perhaps you know someone who has diabetes. According to the American Diabetes Association, those who have diabetes are at a higher risk for coronary (heart) artery disease, heart attack or stroke.

Diabetes can change some of the substances in the blood causing the openings in the blood vessels to narrow or completely clog up resulting in a blockage or slow down of blood flowing in the body. A heart attack occurs when the blood supply to your heart is reduced or cut off. A stroke occurs when a blood vessel leading to or in the brain becomes blocked. Heart attack and stroke are the leading causes of early death in people with diabetes. Two out of three people with diabetes die from heart disease or stroke.
The good news is that you can take steps to prevent heart disease or reduce your chances of having a heart attack or stroke. Lifestyle changes, such as choosing foods wisely and being physically active, as well as taking medication, can help.

What steps can I take to prevent coronary artery disease?
You can lower your risk by keeping your ABCs of diabetes on target with wise food choices, physical activity, and medication. Losing weight can also help you manage your ABCs and prevent heart disease. The closer your numbers are to your targets, the better your chances of preventing heart disease or cutting your risk for heart attack. If you smoke, get help to quit.

A is for A-1-C
An A-1-C tells you your average blood glucose for the past 2 to 3 months. A high A-1-C means that sugar is accumulating in the blood. The American Diabetes Association (ADA) recommends an A-1-C below 7.

B is for blood pressure
When your blood pressure is high, your heart has to work harder than it should. The ADA recommends that you keep your blood pressure below 130/80 (said as “130 over 80”) mmHg. The top number is the pressure as your heart beats and pushes blood into the blood vessels. The bottom number is the pressure in the blood vessels when the heart rests between beats.

C is for cholesterol
Your cholesterol numbers tell you the amount of fat in your blood. Some kinds, like HDL cholesterol, help protect your heart. Other kinds, like LDL cholesterol, can clog your blood vessels and lead to heart disease. Triglycerides are another kind of blood fat that raises your risk for heart disease. Following are the targets suggested by the ADA:

*LDL should be below 100.
*HDL should be above 40 for women and above 50 for men.
*Triglycerides should be below 150.

Make wise food choices
Many people find that making small changes in what they eat can make a big difference in their blood glucose, blood pressure, and cholesterol levels. Below are several strategies for making wise food choices. Choose one or two to try.

• Eat less fat, especially saturated fat (found in fatty meats, poultry skin, butter, 2% or whole milk, ice cream, cheese, palm oil, coconut oil, trans fats, hydrogenated oils, lard, and shortening).
• Choose lean meats and meat substitutes.
• Switch to low-fat or fat-free dairy products.
• Eat at least 5 servings of fruits and vegetables each day.
• Cut back on foods high in cholesterol (such as egg yolks, high-fat meat and poultry, and high-fat dairy products).
• Choose the kinds of fat that can help lower my cholesterol, such as olive oil or canola oil. Nuts also have a healthy type of fat.
• Eat fish two or three times a week, choosing kinds that are high in heart-protective fat (such as albacore tuna, herring, mackerel, rainbow trout, sardines, and salmon).
• Cook using low-fat methods (such as baking, roasting, or grilling foods or by using nonstick pans and cooking sprays).
• Eat more foods that are high in fiber (such as oatmeal, oat bran, dried beans and peas like kidney beans, fruits, and vegetables).
• Eat less salt and sodium (prepackaged foods are VERY high in sodium).

Be physically active
First, check with your health care team to find out which activities will be safe for you. Then think about how you can add more activity to your routine. Begin with 5 minutes a day and gradually add more time working up to doing a total of about 30 minutes of aerobic exercise, such as brisk walking, at least 3 times each week.

Quit smoking
If you’re ready to quit smoking, talk with your health care team. They can help you find ways to quit. North Country Hospital offers several options including hypnosis, group, and one-on-one cessation programs.

It’s never too late to start working on improving your health and taking steps to prevent, or slow the progression of, heart disease. Having diabetes means being even more diligent about taking control of your health. You’re not alone; become an active part of your medical team and arm yourself with the facts about diabetes and heart disease. Visit the American Diabetes Association website at www.diabetes.org/heart-disease-stroke.jsp for more information.

"HEALTHY YOU” is a weekly column prepared by health care providers and staff at North Country Hospital and Health System. For information or to suggest a topic for this column, please call Mary Perkins, Wellness Center Manager, 334-3226, or email mperkins@nchsi.org.