Heart attacks occur at an earlier age in people with diabetes. Heart disease deaths are decreasing in all groups except diabetes, …
Fall 2003
Diabetes
Outlook
Staying Healthy Living
to lower their risk The program encourages everyone with diabetes to follow their ABCs:
Well
Diabetes and heart disease
Do you know the link?
Smoking and lung disease Overeating and obesity Alcohol abuse and liver disease Almost everyone is aware of the link between these unhealthy habits and the problems they cause But not everyone understands the strong link between diabetes and heart disease Heart disease is the number one cause of death in people with diabetes: two out of three people with diabetes die of a heart attack or stroke Yet people with diabetes seem to worry more about blindness and amputations than about heart disease, according to a survey by the American Diabetes Association ADA and the American College of Cardiology ACC Seventy-five percent of people who took the survey admitted to having risk factors for heart disease such as smoking, high cholesterol, high blood pressure, inactivity or being overweight but saw no connection between these problems and their diabetes Recently, the ADA and ACC launched Make the Link, a program that helps people with diabetes understand the link between diabetes and heart disease
see QA on page 4 and learn how
A B C
A1c or hemoglobin A1c test This test
measures your average blood sugar over the past three months Have your A1c checked at least twice a year Your goal: below 7
Heart disease is the number one cause of death in people with diabetes
If your ABCs are not on target, your doctor may prescribe medicine for you to take But remember, medicine is not a substitute for healthy habits Now you know your ABCs But dont forget D, E and F:
Blood pressure As
many as 60 of people with diabetes have high blood pressure Have your blood pressure checked at every doctors visit, and ask your doctor what you can do to keep your blood pressure in the healthy range Your goal: less than 130/80 mmHg
In this issue
The exercise effect: Lowering your heart disease risk
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2 3
DDont smoke E Exercise regularly F Follow a healthy diet
Simple lifestyle changes can go a long way toward reducing your risk for heart problems
High triglycerides or LDL bad cholesterol, or low HDL good cholesterol
Cholesterol Believe it or
not, nearly every adult with diabetes has at least one lipid problem This can lead to clogged arteries and increase your heart attack risk Have your
cholesterol checked at least once a year more often if your doctor recommends it Your goal: LDL cholesterol less than 100 mg/dL; total cholesterol less than 200mg/dL
Are you taking your aspirin?
Healthy recipe: pumpkin cheesecake pudding
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QA
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The heart truth about diabetes
People with diabetes are twice as likely to develop heart disease as people without diabetes Heart attacks occur at an earlier age in people with diabetes Heart attacks are more likely to cause premature death in people with diabetes People with diabetes are five times more likely to suffer a stroke than people without diabetes, and theyre two to four times as likely to suffer a second stroke Heart disease deaths are decreasing in all groups except diabetes, where theyre actually increasing
Source: ADA
Outlookon Exercise
The exercise effect
Lowering your heart disease risk
R
eminders come at you from everywhere — eat less, exercise more, lower your blood pressure, reduce your cholesterol, monitor your blood sugar, and on and on So if you do all these things, what does it get you? A longer life, thats what Lets explore just one of the things you should do to live healthier and longer:
exercise
First, consider what happens to your body if you dont move it Your LDL bad cholesterol, blood pressure and weight get higher and your HDL good cholesterol gets lower — all major risk factors for heart disease Heart-related complications are the number one cause of death in people with diabetes, so, while exercise is important for everyone, its especially important for you
Let your doctor know when youre going to start an exercise program He or she will look at how well controlled your diabetes is and the condition of your heart and circulatory system Your doctor will also tell you whether you have complications that mean you should avoid certain types of exercise For example, if youve lost feeling in your feet, you might want to choose swimming instead of running If youre just getting started, consider walking Try walking 15 or 20 minutes three or four times a week, and gradually increase your speed and distance If you find a physical activity you enjoy, like walking or bicycling, youre more likely to keep it up So, how much, how long and how often? The American Heart Association AHA suggests following the FIT formula to get the most from your exercise program:
Pop
quiz
T est your flu knowledge
Winter and the flu go hand in hand When the wool sweaters come out, so, it seems, do the tissues and hot tea Want to increase your chances of sidestepping the flu this year? Get a flu shot But first, take this quiz and see if youve got your flu facts straight
T T T T T T
F F F F F F
1 You cant get the flu from a flu shot 2 If you got the flu shot last year, you dont need another one 3 If youve never gotten a flu shot and never had the flu before, you dont need one 4 If youre allergic to eggs, you shouldnt get a flu shot 5 The flu can be spread through casual contact through the air 6 If you have a chronic disease like diabetes or heart disease, you shouldnt get a flu shot 7 It doesnt matter when you get a flu shot as long as you get one every year 8 You cant treat the flu with antibiotics Answers are on page 3
F frequency days per week
In its Handbook of Exercise in Diabetes, the American Diabetes Association ADA says that exercising three to five days a week can reduce the risk of heart disease in people with diabetes
I intensity easy, moderate or vigorous
The ADA recommends at least moderate exercises, such as brisk walking, for heart-health
benefits
T time length of each session
The AHA suggests moderate exercise for at least 30 minutes per session
T T
F F
Whats that mean?
Atherosclerosis
A type of hardening of the arteries in which cholesterol, fat and other substances in the blood build up in the walls of arteries As the process continues, the arteries to the heart may narrow, cutting down the flow of oxygen-rich blood and nutrients to the heart
Terms you should know in plain English
Metabolic syndrome
When a person has several disorders of the bodys metabolism at the same time, such as obesity, insulin resistance whether the person has diabetes or not, high blood pressure and high cholesterol Also called insulin resistance syndrome
Lipids
Fatty substances, including cholesterol and triglycerides, that are present in blood and body tissues
Low density lipoprotein LDL
A combined protein and fat-like substance Rich in cholesterol, it tends to stick to the walls of the arteries Sometimes called bad cholesterol
Triglycerides
Lipids carried through the bloodstream to tissues Most of the bodys fat tissue is in the form of triglycerides, stored for use as energy Triglycerides are obtained primarily from fat in
foods
High density lipoprotein HDL
A combined protein and fat-like substance Low in cholesterol, it usually passes freely through the arteries Sometimes called good cholesterol
Definitions are from the National Institutes of Health website wwwnihgov and the American Diabetes Association websit 
e wwwdiabetesorg
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The information contained in this material is not intended to be a substitute for medical care or advice provided by a physician Always consult your physician for appropriate examinations, treatment and care recommendations If you have any questions about this information, you should call your physician Any reference in this material to other organizations or companies, including their Internet sites, is not an endorsement or warranty of the services, information or products provided by those organizations or companies
Outlookon Prevention
Are you taking your aspirin?
f you dont already take an aspirin each day, write ASPIRIN at the top of your list of questions for your doctor An aspirin a day can cut your risk for developing heart disease Two out of three people with diabetes develop heart disease, so this is a prevention strategy worth checking out
I
have protein
in your urine have a total cholesterol level higher than 200 mg/dL - LDL cholesterol higher than 100 mg/dL - HDL cholesterol lower than 45 mg/dL in men and lower than 55 mg/dL in women - triglycerides higher than 200 mg/dL are age 30 or older
Studies have not been done for patients under 30 Ask your doctor for more information
How does aspirin work?
Aspirin helps keep the red blood cells from clumping together, or clotting Some blood clots can lead to heart attack or stroke
How much should I take?
The ADA recommends taking between 81 and 325 mg of coated aspirin a day But your doctor will decide how much is right for you
Who should take it?
The American Diabetes Association ADA recommends daily aspirin for all people with type 1 or type 2 diabetes who are at risk for heart disease Youre considered at risk if you: have a family history of heart disease smoke have high blood pressure are obese
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P mpkin chee u secake puddi ng
Healthy rec ipe
Who shouldnt take aspirin?
Aspirin is not for people with aspirin allergies, a tendency to bleed, or a history of bleeding ulcers or liver disease Also, you shouldnt take aspirin if you already take blood-thinning medicines such as Coumadin or heparin And people under age 21 shouldnt take aspirin because of an increased risk for Reyes syndrome
Answers to the flu quiz from page 2
1 True Flu shots once contained a small amount of active live flu virus, which sometimes caused flu-like symptoms They no longer do You might experience some soreness around the vaccination site or a headache or feel a little tired, but these
symptoms usually go away after a day or so 2 False The flu virus — and the flu vaccine — change every year You need a shot every year to be protected
Sites to see
wwws2mwcom/heartofdiabetes
Sponsored by: American Heart Association AHA Part of the AHA website, The Heart of Diabetes: Understanding Insulin Resistance explains how diabetes can increase your risk for heart attack and stroke Check out these cool spots: Family History Tree Complete your own family tree to check your risk for diabetes and heart disease If you have questions for family members about their health which helps you figure your own risk, you can send them an e-card to get the answers Heart Healthy Tracker Enter information about your blood sugar, blood pressure and cholesterol levels Then print it out and take it to your next doctors visit Thrivers Program Join and get a journal to track your diabetes management progress You also get a free 12-month subscription to Diabetes Positive magazine
also available in Spanish
3 False Consider yourself lucky if youve never gotten the flu But that doesnt mean youll never get it If you dont get a shot, youre at risk
4 True Parts of the flu vaccine are grown in hens
eggs, and the flu shot can cause a reaction in people with egg allergies 5 True The flu virus can be passed from person to person via airborne droplets of respiratory fluids, usually through coughing and sneezing
6 False Getting a flu shot is even more important if you have a chronic disease Its also very important for the elderly For these people, the flu can cause life-threatening complications
7 False The best time to get a flu shot is between September and midNovember — before flu season begins But a late shot is better than no shot at all
false
8 True The flu is a virus, and antibiotics dont work on viruses However, there are some new prescription medicines that can lessen flu symptoms and get you back on your feet faster They usually must be taken within 48 hours of your first symptoms — and they dont work for all types of flu Ask your doctor for more details
true
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Staying
Outlook
Healthy Living
Well
2003 American Healthways, Inc
QA
Q A
QUESTIONS ANSWERS
Q A
My doctor said that I really need to lose weight around my waist Why?
Does your figure resemble an apple — rounder in the middle? If so, your doctors right Extra weight around your waistline also
called intra-abdominal fat can increase your risk for heart disease, especially if youre a woman Fat cells located in the abdomen release fat into the blood more easily than fat cells located elsewhere This can cause insulin resistance see first QA, known to make people more prone to heart disease Find out if you have an apple figure by measuring your waist-to-hip ratio Using a tape measure, measure around your waist an inch above your navel Then measure your hips at their widest point Divide your waist measurement by your hip measurement A measurement over 08 for a woman or over 10 for a man is considered unhealthy Say a womans waist measures 32 inches and her hips measure 36 inches Her waist-to-hip ratio is 89, meaning shes at increased risk for heart disease
Source: American Academy of Family Physicians
Why are people with diabetes more at risk for heart disease?
High blood sugar levels can damage your blood vessels, which speeds up the process of atherosclerosis ATH-ur-ohscluh-ROW-sis, also known as clogged arteries Another problem is insulin resistance Common in people with type 2 diabetes, insulin resistance means that your body cant use insulin the way it should This
causes the pancreas to release more insulin in an effort to keep your blood sugar levels normal Because the insulin is unable to do its job, blood sugar builds up and stays high Your body may respond in a number of ways, including storing excess fat around your middle, increasing your blood pressure and bad cholesterol levels, and decreasing your good cholesterol levels — all starting points for heart disease Note that people with type 1 diabetes and people without diabetes can also become insulin resistant
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Source:cchealth.org
