Health & Fitness

By Dr. Kathleen Prendergast

Heart health should always be a concern, but for people with diabetes, it is extremely important. Diabetes is a disorder in which your body doesn't produce or process insulin correctly and is often directly connected to cardiovascular disease. In fact, a person with diabetes has twice the chance of developing heart disease as someone without this condition. Several other factors to consider:

• A diabetic who has had a previous heart attack has a much greater risk of having another.
• Diabetics develop cardiovascular disease at a much earlier age than others.
• Diabetics who have heart attacks are more apt to die as a result.

The connection between diabetes and heart disease starts with high blood glucose (sugar) levels. With time, the high glucose in the bloodstream damages the arteries, causing them to become stiff and hard. Fatty material that builds up on the inside of these blood vessels can eventually block blood flow to the heart or brain, leading to heart attack or stroke.

Although statistics show diabetics at an increased risk for heart disease, prevention is possible.

Be active

Aim for about 30 minutes of exercise most days. That can be broken down into 10-minute increments and still give you all the heart benefits.

Consider low-dose aspirin

Talk to your doctor about whether you should take a low dose of aspirin every day, which may reduce the risk of developing cardiovascular disease. However, there are risks, and aspirin therapy is not for everyone.

Eat a heart-healthy diet

Reduce consumption of high-fat and cholesterol-laden foods such as eggs and fried foods, and eat more high-fiber foods, including whole grains, vegetables, and fruits. Try to limit prepared snack foods because many contain trans fats, which contribute to diabetes and heart disease.

Maintain healthy weight

Seek the help of a registered dietitian to come up with a healthy but reasonable diet that you can maintain.

Watch your cholesterol

LDL (bad) cholesterol should be below 100; HDL (good) cholesterol should be higher than 40 in men and higher than 50 in women. Triglycerides should be lower than 150.

Maintain blood glucose levels

Your doctor will help you to determine the right range. You can check on your efforts by having A1C tests at least twice a year; these reveal your average blood sugar level for the most recent two to three months. Most people should aim for an A1C of seven or below.

Maintain a controlled blood pressure

A preferred level is 130/80 or lower. Be sure to have your pressure checked during every visit to your doctor's office.

Quit smoking. Talk to your doctor about getting help when you're ready to quit.

Take all of your medications as prescribed

If you have diabetes and develop heart disease, treatment — first and foremost — will include lifestyle changes such as those mentioned above. You might also need medication to lower your blood glucose, blood pressure, or cholesterol level and to treat any heart damage. In some cases, you may need surgery or another medical procedure to treat heart disease. Treatment for each person will be different, depending on the type of cardiovascular complication that you might have.

Finally, if you think you are having a heart attack, seek medical help immediately because early treatment can decrease the potential damage to your heart.

Dr. Kathleen Prendergast is an endocrinologist at the University of Maryland Diabetes and Endocrine Center at Baltimore Washington Medical Center. She can be reached at 410-787-4940. Dr. Prendergast is hosting a seminar on cardiovascular disease and diabetes Feb. 15 at BWMC. Please call for reservations 410-787-4367.