for ongoing coverage of National Diabetes Awareness Month the needs and habits of adults with type 1 diabetes. Even though Justin has had diabetes …
Welcome to the American Heart Associations Heart Of Diabetes program
The Heart Of Diabetes is a national program to help you reduce your risk for cardiovascular disease which includes heart disease and stroke, the leading cause of death for people with diabetes The Getting to the Heart of Diabetes Guide will help you learn how cardiovascular disease, diabetes and insulin resistance are interconnected and what you can do to improve your health After reading the booklet, take the next step by putting your knowledge into action Enroll in the Heart Of Diabetes Thrivers program by filling out and mailing the card at the back of this booklet As part of the program, youll receive A journal to track your progress in managing your diabetes and reducing your risk Incentives throughout the year to help you stay motivated Just complete the health risk assessment card and mail it back to the American Heart Association You should begin to receive your materials in 68 weeks
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Are people with diabetes at high risk for cardiovascular disease CVD? Yes People with diabetes are at high risk for such cardiovascular disorders as coronary heart disease heart attacks, stroke and peripheral vascular
disease From two-thirds to three-fourths of people with diabetes die from CVD
What are the major modifiable risk factors for CVD?
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congestive heart failure and other complications, too Diabetes causes nerve damage that makes painless heart attacks more likely and harder to diagnose Heart attacks are more likely to be fatal in people who have diabetes than in those who dont
Smoking High blood cholesterol High blood pressure
Physical inactivity Obesity and overweight Diabetes mellitus
Diabetes lowers HDL good cholesterol and raises triglycerides blood fats People with diabetes also tend to have higher than normal LDL bad cholesterol These effects increase the risk of heart disease and stroke About 80 percent of people with diabetes are overweight or obese, and many of them are not physically active Many people with diabetes also have high blood pressure These factors raise their risk for heart disease and stroke even more Contact the American Association of Diabetes Educators at diabeteseducatororg to help you learn how to prevent
How dangerous is diabetes? Its very dangerous Just look at these facts:
Diabetes kills or contributes to the deaths of more than 213,000 Americans each year People with diabetes are two to four times more likely to have heart disease or a stroke Their heart disease also tends to be more severe They have a higher risk of
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problems that can be associated with diabetes Find an educator on the General Public area of the Web site at diabeteseducatororg/FindAnEduc/indexhtml, or 1-800-TEAMUP4 Besides being a risk factor for CVD, diabetes also can cause or lead to blindness kidney disease nerve disease limb amputations Many people with uncontrolled diabetes also report depression and living a less active life What is diabetes mellitus? Diabetes mellitus is a progressive disease in which your body doesnt make enough insulin and doesnt respond properly to insulin Insulin is a hormone made in the pancreas It helps the body to properly utilize sugar If you have diabetes, your blood glucose blood sugar levels are too high
Diabetes is defined as a fasting blood glucose of 126 milligrams per deciliter mg/dL or more measured on two occasions Pre-diabetes is a condition in which blood sugar glucose levels are higher than normal but not yet diabetic People with
pre-diabetes have one of these conditions: impaired fasting glucose fasting blood sugar of 100 to less than 126 mg/dL impaired glucose tolerance fasting blood sugar of 100 to less than 126 mg/dL and a blood sugar level between 140 and 199 mg/dL two hours after taking an oral glucose tolerance test The American Diabetes Association recommends that all adults have a fasting blood glucose test at age 45 If your results are normal, get retested every 3 years If youre at risk of diabetes or have symptoms, dont wait Take the test at a younger age If your results are higher than normal but not yet diabetic, talk to your doctor about your risk of developing diabetes and the steps you can take to prevent it
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Persistent high levels of blood glucose cause symptoms that may alert you to the development of diabetes These symptoms can include hunger extreme thirst frequent urination unexplained weight loss blurry vision fatigue Type 2 diabetes is the most common form It appears most often in middle-aged adults; however, adolescents and young adults are developing type 2 diabetes at an alarming rate It develops when the body doesnt efficiently use the insulin it makes insulin resistance and
doesnt make enough insulin Type 2 diabetes may have very mild or no symptoms Type 1 diabetes usually appears at younger ages In it, the pancreas makes little or no insulin Without daily injections of insulin, people with type 1 diabetes wont survive
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What is insulin resistance? Insulin resistance occurs when the body cant use insulin efficiently To compensate, the pancreas releases more and more insulin to try to keep blood sugar levels normal Gradually, the cells that make insulin become defective and fewer in number When the pancreas cant keep up, glucose levels rise and diabetes develops This is why insulin resistance is considered a core metabolic dysfunction About 4969 million Americans may have insulin resistance One in four of them will develop type 2 diabetes Hyperglycemia too much glucose in the blood and hyperinsulinemia too much insulin in the blood are signs of insulin resistance What are risk factors for insulin resistance and diabetes? Risk factors for insulin resistance and diabetes you can control obesity physical inactivity Risk factors that you cant control genetics increasing age
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Theres no easy test to measure insulin resistance If you think you might be insulin resistant, based on these risk factors, consult your healthcare provider Everyone should take steps to reduce their risk for diabetes But its even more important for Hispanics and African Americans, because they have about twice the risk of diabetes as Caucasians That means if youre Hispanic or African American, you need to be especially careful to eat a healthy diet, be physically active on most days of the week, and maintain a healthy weight How are insulin resistance, diabetes and CVD related? Pre-diabetes and type 2 diabetes usually result from insulin resistance In fact, insulin resistance seems to predispose to both CVD and diabetes When insulin resistance or diabetes occur with other CVD risk factorssuch as obesity, high blood pressure, abnormal cholesterol and high triglycerides, the risk of heart disease and stroke increases even more
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Insulin resistance is linked with atherosclerosis fatty buildups in arteries and blood vessel disease, even before diabetes is diagnosed How can I reduce my risk of insulin resistance, diabetes and CVD? Modifying life habits is the key to
preventing CVD and diabetes Drug therapy may still be required to control risk factors, particularly when theyre due to genetics and/or aging You can take these actions starting today: Lose weight Excess weight increases your risk of diabetes and heart disease Obesity strains your heart and raises blood pressure It also raises LDL bad cholesterol and triglyceride blood fat levels It lowers HDL good cholesterol levels If youre overweight, losing even 10 to 20 pounds can help lower your heart disease risk Weight loss helps to lower insulin resistance, body fat and blood pressure levels Eating fewer high-fat foods, reducing calories and increasing your physical activity will help you lose extra pounds and stay at a healthy weight
Be physically active Regular physical activity helps lower insulin resistance That means your body can use its own insulin more effectively Physical activity also prevents or delays diabetes, reduces blood pressure and helps reduce your risk of heart attack and stroke Ask your healthcare provider which physical activities are best for you Start out with 510 minutes at a moderate pace and work up to 30 minutes 46 times a week Control blood cholesterol
People with diabetes should know their LDL cholesterol, HDL cholesterol and triglyceride levels LDL higher than 100 mg/dL, HDL lower than 40 mg/dL and triglycerides higher than 150 mg/dL put you at higher risk for CVD, diabetes and insulin resistance Eat a diet low in saturated fat, trans fat and cholesterol to keep your blood cholesterol within healthy limits
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Control blood pressure If you have diabetes, your blood pressure should be lower than 130/80 mm Hg millimeters of mercury to reduce your risk for CVD If your blood pressure is 130/80 mm Hg or higher, your doctor will likely prescribe medicine to lower it You should also be more physically active, lose weight if needed, and eat less sodium salt if youre sodium sensitive Control diabetes If you have diabetes, its very important to control your blood glucose and your other risk factors for CVD This will help reduce your risk of heart attack or stroke If youre pre-diabetic or insulin resistant, take steps now to delay or prevent it from becoming diabetes This will also help reduce your risk of developing CVD Stop smoking Smoking cigarettes and other tobacco products raises the risk of heart attack and stroke It also
increases the risk of cancer, lung disease, etc If you smoke, get help to quit, and avoid others tobacco smoke
What about stroke? If you have diabetes, you need to control the risk factors listed previously Why? Because they increase the risk of both heart disease and stroke But watch out for these stroke risk factors, too: Previous heart attack or stroke If youve had a heart attack, youre at higher risk of having a second attack or a stroke If youve had a stroke, youre at much higher risk of having another one or having a heart attack Carotid or other artery disease Fatty deposits plaque in a carotid artery one of the neck arteries leading to the brain raise stroke risk Surgery called carotid endarterectomy might be used to remove the plaque buildup Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles People with diabetes have a higher risk of peripheral artery disease In turn, people with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke
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Atrial fibrillation In this heart rhythm disorder, the hearts upper chambers quiver instead of beating effectively This lets the
blood pool and clot If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results Other heart disease People with coronary heart disease or heart failure have a higher risk of stroke Dilated cardiomyopathy an enlarged heart, heart valve disease and some types of congenital heart defects also raise stroke risk Transient ischemic attacks TIAs These are warning strokes that only last a short time Theyre an important indicator of an impending stroke Dont ignore them Get medical attention immediately
Certain blood disorders A high red blood cell count makes blood clots more likely, increasing stroke risk Doctors may treat this problem by removing blood cells or prescribing blood thinners Sickle cell anemia is a genetic disorder that mainly affects African Americans Sickled red blood cells are less able to carry oxygen to the bodys tissues and organs They also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke
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Can I control diabetes? Yes, and its very important to do so When a doctor detects diabetes, you may be asked to eat more healthfully, control your weight and be more physically
active You also may need prescription drugs to keep it in check In recent years, researchers have developed new medications to treat type 2 diabetes Insulin sensitizers, for instance, help the insulin work more effectively Some prescription drugs also positively affect lipid levels Talk to your doctor about insulin resistance and the best therapy options for you Its critical for people with diabetes to have regular checkups and take responsibility for the day-to-day management of their diabetes by participating in diabetes self-management education or training Work closely with your healthcare team to manage your diabetes and control other risk factors for CVD Many people with diabetes dont eat right or get the exercise they need Because of this, they suffer devastating diseases like heart attack and stroke Dont make this mistake Take your insulin resistance and/or diabetes seriously
What should I know about healthy eating? Healthy food habits can help you reduce three major risk factors for heart attack and stroke — high blood cholesterol, high blood pressure and excess body weight The American Heart Association Eating Plan for Healthy Americans outlines a healthy diet Its based
on these dietary guidelines, which are easier to follow than you may think: Eat a variety of fruits and vegetables Choose 5 or more servings per day Eat a variety of grain products, including whole grains Choose 6 or more servings per day Eat fish at least twice a week, particularly fatty fish, such as mackerel, lake trout, herring, sardines, albacore tuna and salmon Include fat-free and low-fat milk products, legumes beans, skinless poultry and lean meats Choose fats and oils with 2 grams or less of saturated fat per serving 1 tablespoon Examples are liquid and tub margarines, and canola, olive, corn, safflower and soybean oils Balance the number of calories you eat with those you use up each day to maintain your best weight Walk or do other activities for at least 30 minutes on most or all days To lose weight, do enough activity to use up more calories than you eat every day
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Limit your intake of foods high in calories or low in nutrition, such as high-sugar soft drinks and candy Limit foods high in saturated fat, trans fat and/or cholesterol Examples include full-fat milk products, fatty meats, tropical oils and partially hydrogenated vegetable oils Egg yolks are high in
cholesterol Instead choose foods low in saturated fat, trans fat and cholesterol, such as fruit and vegetables, grain products, fish, fat-free and low-fat milk products, legumes beans, skinless poultry and lean meats Eat less than 6 grams of salt sodium chloride per day Thats about 1 teaspoon of salt, or a daily sodium intake of less than 2,400 mg Limit your alcohol intake If you drink alcohol, have no more than one drink per day for a woman and no more than two per day for a man One drink means it has no more than 1/2 ounce of pure alcohol Examples are 12 oz one can of beer, 4 oz of wine, 11/2 oz of 80-proof spirits or 1 oz of 100-proof spirits Following this eating plan will help you enjoy a healthy, nutritious diet This may help you gain such benefits as a healthy body weight, a desirable blood cholesterol level
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and a normal blood pressure Every meal doesnt have to meet all the guidelines Apply the guidelines to your overall eating pattern over at least several days
These guidelines may do more than improve your heart health They may reduce your risk for type 2 diabetes, some forms of cancer and other health problems, too
What should I know before I increase my physical activity? Physical activity is as important as your eating plan It will help you manage your diabetes, control your weight and blood pressure, and reduce your risk of heart disease and stroke Physical activity burns calories and helps lower blood glucose levels That helps your body use food for energy more efficiently Exercise also may help insulin work better Physical activity improves blood flow through the small blood vessels It improves your hearts pumping power, too Before you start, talk with your healthcare provider This is especially important if your blood glucose isnt well controlled Your healthcare provider can recommend an exercise plan suited to your current fitness level, any special health concerns and your diabetes treatment plan Some complications of diabetes make certain types of physical activity safer than others
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If you have type 2 diabetes and use insulin or pills to control it, check your blood glucose level before and after exercising If its low, you may need a snack If you have type 1 diabetes, your activity plan must fit with your eating plan and when you take your insulin shots You need to check your
blood glucose level before each exercise session If its low, have a snack first You also need to know the signs of insulin reaction and what to do if it occurs How can I become more physically active? Like changing your eating habits, becoming physically active takes time Set goals for physical activity and work toward reaching them Talk with your doctor or exercise specialist about realistic ways to reach your goals and recommended blood glucose controls Make your goals specific, reasonable and measurable Most important, write them down and put them where youll see them often Keep a log or journal of your physical activity, and review it at the end of your goal period Reward yourself when you reach each goal You dont have to be an athlete to cut your risk Start by being active for 10 minutes a day and work up to at least 30 minutes of activity most or all days of the week Go for a short walk before breakfast, after dinner or both Look for other ways to add activity to your day For example, take the stairs instead of the elevator, or park farther from your destination and walk
Regular physical activity offers many benefits It can help you control diabetes and reduce your risk for
heart disease and stroke Here are some other benefits of physical activity you may experience and enjoy: Feel better Look better Gain self-esteem Meet new friends Move easier Become stronger Have more energy Learn new skills Reduce stress
Where can I learn more about diabetes, nutrition and physical activity? For information about diabetes, visit our Web site at americanheartorg/diabetes For general information on nutrition and physical activity, visit americanheartorg or call 1-800-AHA-USA1 1-800-242-8721 American Heart Association cookbooks are available in local bookstores and online Many of our educational booklets are also available from healthcare providers For options to consider when timing restaurant eating with some diabetes medications, see the American Diabetes Association Web site, diabetesorg, under Nutrition Recipes and Your Guide to Eating Out
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Heart Attack Warning Signs Some heart attacks are sudden and intense — the movie heart attack, in which a person dramatically gasps, clutches his or her chest and drops to the ground, and no one doubts whats happening But most heart attacks start slowly, with mild pain or discomfort Often the people
affected arent sure whats wrong and wait too long before getting help Here are some of the signs that can mean a heart attack is happening Chest discomfort Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back It can feel like uncomfortable pressure, squeezing, fullness or pain Discomfort in other areas of the upper body Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach Shortness of breath This feeling often comes along with chest discomfort But it can occur before the chest discomfort Other signs These may include breaking out in a cold sweat, nausea or lightheadedness If you or someone youre with has chest discomfort, especially with one or more of the other signs, dont wait longer than five minutes before calling for help Call 9-1-1Get to a hospital right away
Note: People with diabetes are more likely to have diminished or silent symptoms
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Calling 9-1-1 is almost always the fastest way to get lifesaving treatment Emergency medical services EMS staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by
car The staff are also trained to revive someone whose heart has stopped Youll also get treated faster in the hospital if you come by ambulance If you cant access the EMS, have someone drive you to the hospital right away If youre the one having symptoms, dont drive yourself, unless you have absolutely no other option Stroke Warning Signs Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause Not all these warning signs occur in every stroke If some start to occur, call 9-1-1 and get emergency medical help immediately
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Source:dhss.mo.gov
