The diabetes/cardiac connection
The threat of diabetes looms over our overweight nation, but many people think that if they fall victim, they'll just watch what they eat and take insulin if necessary. No big deal, right? Wrong. Study after study is showing that having diabetes is a big deal - the latest ones show that it's even worse than most doctors previously thought. An article in Harvard Heart Letter reports that heart attacks and strokes are four times more common among people with diabetes, that these episodes occur earlier in life and that they are more likely to be fatal than in people who do not have the disease.
Dr. Claresa Levetan, M.D. is an endocrinologist on the staff of Thomas Jefferson Medical School in Philadelphia and in the forefront of diabetes care as an associate editor of Diabetes Forecast, the publication of the American Diabetes Association. She adds yet another fact to this troubling situation: People with diabetes who have never had a heart attack are as likely to develop one as a nondiabetic patient who has just had an attack.
Diabetes is a complex disease, says Dr. Levetan, and it's about much more than insulin response, diet and exercise. For some reason, in people with diabetes, the LDL cholesterol (the kind that causes problems) is denser and more dangerous than the light fluffy LDL found in nondiabetics. Dr. Levetan adds that even if total cholesterol isn't high in diabetics, because of the type of LDL they have, patients are more apt to have plaque, and it is more likely to break off and cause clots.
The ABCs of Prevention
Dr. Levetan has advice for those who already have diabetes. She says to be rigorous about following what's called the "ABC program." Every three months, have your A1C test (an indicator of how well your diabetes is being controlled)... keep your Blood pressure under 130/80 mg/dl... and keep LDL Cholesterol levels under 100. To reach these levels, she has her patients adopt a healthy eating and exercise regimen. If that doesn't bring the problems in line, she prescribes medication, including statins for cholesterol control. This is a case where the risk for heart problems outweighs the risk from taking statins.
For those who are not diabetic, Dr. Levetan has strong words of advice - do whatever you must to avoid getting diabetes. This includes keeping to a diet of nutrient-rich foods and exercising regularly. Daily Health News contributing editor Andrew L. Rubman, ND, says that dietary supplements that include chromium can help gain better control of glucose metabolism.
Those who are age 30 or older (now the recommended age for screening) with a family history of diabetes should have a fasting glucose test (a simple blood test taken before eating in the morning.) This test will determine if you fall into the prediabetic category (blood glucose of 100 to 125). If you do, talk to your doctor immediately about gaining control.
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