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Kos Diabetes Group: Diabetes and Heart Disease [1]

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Date: 2022-12-09

Most people who have Type 2 diabetes also have some other health problems. One of those can be heart disease. Over time, high blood sugar can damage blood vessels and the nerves that control your heart. People with diabetes are also more likely to have other conditions that raise the risk for heart disease like high cholesterol and high blood pressure.

Your risk for heart disease increases with age, especially in people of color and for those who are over 65. Your risk for heart disease is greater if you are male rather than female, whether you have diabetes or not. While the average age for a heart attack is 64.5 for men and 70.3 for women, nearly 20 percent of those who die of heart disease are under the age of 65. People with diabetes tend to develop heart disease at a younger age than people without diabetes. Adults with diabetes are nearly twice as likely to have heart disease or stroke as adults without diabetes.

If you do have diabetes, other factors can add to your chances of developing heart disease or having a stroke. An individual in their sixties who has both diabetes and heart disease has an average reduction in life expectancy of about 15 years.

What are the other risks that can increase your chances of heart disease?

Smoking

Smoking raises your risk of developing heart disease. If you have diabetes, it is important to stop smoking, because both smoking and diabetes narrow blood vessels. Smoking also increases your chances of developing other long-term problems such as lung disease, lower leg infections and ulcers, and foot or leg amputation.

High blood pressure

If you have high blood pressure your heart works harder to pump blood. High blood pressure can strain your heart, damage blood vessels, and increase your risk of heart attack as well as increase your risk for stroke, and eye or kidney problems. Have your blood pressure checked regularly and work with your doctor to control or lower high blood pressure.

Abnormal cholesterol levels

Cholesterol is a type of fat, produced by your liver and found in your blood. You have two kinds of cholesterol in your blood: LDL and HDL. LDL, often called “bad” cholesterol, can build up and clog your blood vessels. High levels of LDL cholesterol raise your risk of developing heart disease. HDL is sometimes called “good cholesterol.” Higher levels of HDL is linked to lower risk for heart disease and stroke. To improve LDL and HDL levels, limit the amount of fat in your eating plan, eat more plant-based foods, and get regular physical activity.

Another type of blood fat, triglycerides, also can raise your risk of heart disease when the levels are higher than recommended by your health care team.

Obesity and belly fat

Being overweight or obese can make it harder to manage your diabetes and raise your risk for many health problems, including heart disease and high blood pressure. Excess belly fat around your waist, even if you are not overweight, can raise your chances of developing heart disease.

You have excess belly fat if your waist measures

more than 40 inches and you are a man

more than 35 inches and you are a woman Even a modest amount of weight loss (like 5-10 lbs) will help improve your glucose control.

Chronic kidney disease

Heart disease is closely linked with chronic kidney disease, a condition in which your kidneys are damaged and can’t filter blood the way they should. Having diabetes is a risk factor for developing kidney disease, which affects about 40% of people with diabetes. Other risk factors for developing kidney disease are high blood pressure and a family history of kidney failure.

If you have risk factors, get tested for kidney disease and protect your kidneys by making healthy food choices, being more active, aiming for a healthy weight, and managing health conditions that cause kidney damage.

Family history of heart disease

A family history of heart disease may add to your chances of developing the condition. If one or more of your family members had a heart attack before age 50, you have double the chance of developing heart disease compared with people who have no family history of the disease.4

You can’t change whether heart disease runs in your family. But if you have diabetes, it’s even more important to take steps to protect yourself from heart disease and decrease your chances of having a stroke.

Luckily, the steps you take to manage your diabetes also help lower your chances of having heart disease and it’s as easy as your ABCs.

A is for the A1C test which shows your average blood glucose level over the past three months. The higher your A1C number, the higher your blood glucose levels have been during the past three months. The A1C goal for many people with diabetes is below 7%. Some people may do better with a slightly higher A1C goal. Your A1C goals may also change as you get older and your lifestyle changes. Ask your health care team what your goal should be.

B is for blood pressure which is a measure of the force of your blood against the wall of your blood vessels. If your blood pressure gets too high, it makes your heart work too hard. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be.

C is for cholesterol, a form of fat found in your blood. A buildup of cholesterol in your veins can cause a heart attack. Ask your health care team what your cholesterol numbers should be. If you are over 40 years old, you may need to take medicine, such as a statin, to lower your cholesterol levels and protect your heart. Some people with very high LDL (“bad”) cholesterol may need to take medicine starting at a younger age.

Quit now. It will add years to your life.

S is for stop smoking. Quitting smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels, so your heart has to work harder. E-cigarettes aren’t a safe option either.

By quitting smoking

you will lower your risk for heart attack; stroke; nerve, kidney, and eye disease; and amputation

your blood glucose, blood pressure, and cholesterol levels may improve

your blood circulation will improve

you may have an easier time being physically active

Take medicine to protect your heart

Medicines such as statins or a daily aspirin regimen may be an important part of your treatment plan. Your doctor will prescribe medicine based on your specific needs. It is commonly believed that metformin - the first-line treatment for Type 2 diabetes - reduces the risk of and improves the clinical course of heart failure. Other medicines may help you:

meet your A1C (blood glucose), blood pressure, and cholesterol goals.

reduce your risk of blood clots, heart attack, or stroke.

treat angina or chest pain that is often a symptom of heart disease. Angina can also be an early symptom of a heart attack.

treat heart failure, which is a form of heart disease in which your heart cannot pump blood well enough for your body to work properly.

What are the warning signs of heart attack?

pain or pressure in your chest that lasts longer than a few minutes or goes away and comes back

pain or discomfort in one or both of your arms or shoulders, or your back, neck, or jaw

shortness of breath

arrhythmia (problem with the rate or rhythm of your heartbeat)

sweating or light-headedness

indigestion or nausea

fatigue

swollen feet and ankles

Call 9-1-1 right away if you have any of these warning signs of a heart attack because treatment works best when it is given right away. Warning signs can be different in different people. You may not have all the listed symptoms. Women may experience chest pain, nausea, and vomiting; feel very tired (sometimes for days); and have pain that spreads to the back, neck, throat, arms, shoulders, or jaw.

A diabetic can have a heart attack without any warning signs or their symptoms may be very mild. Because diabetes can affect your nerves, there is a risk that your heart attack may be painless or “silent.” Your health care provider might need to do special tests to see whether you've had a heart attack.

As always, the best preventative for diabetes complications is to keep your daily glucose level in range and see your doctor as recommended so any problems can be caught early and dealt with before they become huge complications.

Next week brillig will be taking over. Hopefully, she will have a delicious recipe or two for us to try for the holidays.

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[1] Url: https://www.dailykos.com/stories/2022/12/9/2140714/-Kos-Diabetes-Group-Diabetes-and-Heart-Disease

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