February is American Heart Month, a time when people think of the human heart as a symbol of love. During the month of Valentine’s Day, we see more hearts and bright, red colored clothing than any other time during the year. While purchasing a delicious, dark, chocolate heart for your valentine, use this month to learn more about your risks for heart disease and stroke along with ways to stay healthy.
What is the Heart and Diabetes Connection?
Heart disease which includes heart attack, cardiac arrhythmias, cardiomyopathy and heart failure as well as stroke are the leading causes of disability and death in people with type 2 diabetes. Most people with diabetes do not understand the correlation between diabetes and heart disease but adults with diabetes are 2-4 times more likely to have heart problems than people without diabetes. Much of the process for heart disease may occur prior to your diabetes diagnosis so you want to make changes as soon as possible. Fortunately, the American Heart Association deems diabetes to be one of the many controllable risk factors for heart disease.
What are Possible Symptoms of Heart Disease?
Since heart disease is a leading killer, you should be aware of the signs and symptoms. Warning signs include chest pain or tightness, cold sweats, pain in the arm, jaw, back or neck, shortness of breath, dizziness, nausea and light headedness. Men and women may experience different symptoms. People with diabetes may not have any symptoms which is often called, “a silent heart attack.” If you suspect you are having a heart attack, chew a 325mg aspirin and call 911. Do not wait! The sooner a heart attack is treated, the better the results.
What Does an Effective Diabetes Plan Include to Reduce Your Heart Disease Risk?
An effective diabetes self-management plan includes starting with a primary care, internist or endocrinologist who will help you take charge and monitor your diabetes. The next step should be to find a diabetes educator or dietitian that specializes in diabetes to achieve a complete care plan. You may be entitled to a 10-hour diabetes education course through your insurance plan. Medicare does cover diabetes education and many commercial plans follow Medicare guidelines. Research through your local ADA where an accredited diabetes management plan is.
Ways You Can Manage Diabetes to Keep Heart Problems Away.
There are many ways to self-manage diabetes. The first thing you should consider is monitoring your blood glucose levels at home. Although your physician will track bloodwork every 3 months to help maintain your control, it is important for you to understand daily blood sugar trends. Your MD will test your 3-month A1C, which is an average of 2-3 months of previous blood sugars. According to the ADA (American Diabetes Association) your A1C should be under 7% and the AACE (American Association of Clinical Endocrinologists) suggest a value under 6.5%. You and your health care provider will decide which value is best for you depending on your over-all health. The elderly, people with heart disease and people with frequent hypoglycemia may be required to maintain a higher A1C. With a diabetes diagnosis, you are entitled to a home glucose monitor through your insurance plan or you can purchase one out of pocket. Make sure to match the strips to your meter since they will only operate with the correct strips. You and your physician will come up with a schedule of when to test. Daily blood glucose testing can give you insight into your eating plan, exercise, stress levels, underlying infections and how your diabetes medication is working. People on insulin usually require more frequent daily testing especially if they are giving insulin dosages based on their blood sugars. Most people with diabetes usually test first thing in the morning, but you and your doctor should also consider varying the times and include a check 2 hours after a meal to get a clearer understanding of how blood sugars react during the entire day. Discuss a plan for the best information.
Where Does Exercise Fit in with Heart Disease?
Daily regular, physical activity is paramount for diabetes control and cardiac health. The heart is a muscle and must be trained as a muscle. Although it will not get bigger since it sits in your chest cavity, it will get stronger and work more efficiently with exercise. “Exercise pre-conditioning may offer immediate and lasting cardio protection. The idea is to train the heart and coronary arteries to brief periods of ischemia or lack of blood flow”, according to a study published in JAMA Cardiology. Exercise conditions the heart, uses sugar for muscle energy and increases the metabolic rate which are all health benefits. Although exercise helps maintain weight loss more than aid in weight loss, it is still very important for cardiac health. Always check with your physician prior to starting a program. Start with a simple walking program of 10-15 minutes a day. Try to work up to 30-60 minutes a day especially if you break up the walks. Consider using bands, hand weights or weight machines to build muscle strength. Always include some form of stretching and balance exercise for a complete fitness plan. If you had a heart attack or bypass surgery, you may be entitled to cardiac rehab which is an organized 12-week exercise program specifically for heart patients that is supervised and monitored by registered nurses, exercise physiologists and physicians. Exercise classes provide social settings, may help form friendships and may reduce social isolation especially for the elderly.
Meal Planning for Your Heart?
A well-balanced, whole food diet is good for your heart and diabetes control. Working with a CDE or dietitian can be extremely helpful if you are confused about proper food choices. Eating well for your heart should include lots of fresh vegetables that can be eaten cooked or raw. Learn to roast, sauté, or steam vegetables to furnish an excellent source of fiber. Include fruits in moderation since they are carbohydrates. Include berries such as raspberries, blueberries, strawberries and blackberries since they are a perfect choice since they are low in calories, high in fiber and provide multiple antioxidants. Eat low-fat dairy for calcium and bone health. Include plain Greek yogurt, low-fat cottage cheese and low-fat milk. Include lean sources of protein like fish that is rich in Omega 3s such as salmon, tuna, mackerel and sardines for improved heart health. Include seeds such as flax, chia and hemp seeds for rich oils and fiber. Cook with olive, canola or avocado oil. Include whole grains such as wild rice, bulgur and amaranth, in moderation. Choose poultry without the skin and cut down on saturated fats such as red meat, whole milk and high fat cheese. The latest research for eating full fat foods is mixed. The American Heart Association and the American College of Cardiology still recommends low-fat varieties of foods for heart health. Avoid processed, trans-fat and sugary foods which can play havoc with your heart. As with diabetes, avoid sweet drinks including fruit juice, ice tea and soda. The findings in Open Heart, a cardiac journal, state, “added sugars may lead to the development of chronic heart disease and insulin resistance. Diets containing more than 25% of calories from added sugars were associated with a three-fold risk for cardiovascular mortality.”
What are Other Risk Factors for Heart Disease?
Other risk factors for heart disease besides diabetes include obesity, or having a waist that is larger than 35 inches for a woman or 40 inches for a man. Low levels of HDL cholesterol or “good” cholesterol, and high levels of LDL cholesterol or “bad” cholesterol is a cardiac risk factor. High LDLs are often genetic and may require medications called statins if diet, exercise and weight loss do not bring your numbers down. HDLs should be a minimum of between 50-60 mg/dl and LDLs should be under 100 mg/dl if you have heart disease or under 70 if you have diabetes and heart disease. Triglycerides are another important number to watch and should be under 150 mg/dl. Cutting way down on simple sugars will help lower triglycerides. High blood pressure is an additional risk factor for developing cardiovascular disease. The new guidelines state blood pressure should not exceed 130/80 for proper management. Stress and anxiety may be a cause of high blood pressure and you may need to incorporate deep breathing and meditation to your life. Most people have essential hypertension which means there is no real reason for the elevation and you may require blood pressure medication for control, so check with your physician. Smoking puts you at a higher risk for heart disease and stroke, which makes it important to quit this bad habit. Try going “cold turkey”, getting hypnosis, going to support groups or taking Chantix. Just quit! Drinking excessive alcohol and a sedentary lifestyle are also risk factors for cardiac disease.
What Does Heart Disease Cost the US?
During American Heart Month, people are reminded cardiovascular disease is the number 1 killer of men and women in the United States. It is also the leading cause of disability. According to the CDC with research from 2015, The Division for Heart and Stroke Prevention states, “American’s suffer 1.5 million heart attacks and strokes each year and heart disease contributes more than 320 billion annually in health care costs.”
Who May be at Greater Risk for Heart Disease?
People with a family history of cardiovascular disease are at a higher risk for heart disease themselves. Men are at greater risk at an earlier age, until women go through menopause, then heart disease levels equal out. Aging is an added risk factor for both. An additional factor may be geographical location. Studies conducted in 2013 indicate that heart disease is more prevalent in certain parts of the country. The states with the highest incidence include Ohio, Arkansas, Michigan, Mississippi, Texas, Tennessee, Louisiana, and Alabama. This may be related to their current diet, smoking and rate of obesity.
What is the Good News?
Cardiovascular disease deaths may be prevented or lessened through healthy lifestyle habits including the proper management of type 2 diabetes, high blood pressure, high cholesterol and obesity. Do not smoke and drink in moderation if you do drink alcohol. Get a check-up annually for your heart or as recommended by your physician. Do not run out of medications and take them properly. Sleep 7-8 hours nightly for essential body repair. Consider losing between 5-10% of your total body weight which can make a significant difference especially for your blood sugars and diabetes control. Keep your gums healthy since inflamed gums and periodontal disease is a known risk factor for heart problems.
American Heart Month in February coincides with Valentine’s Day, a time to remember our hearts and how important they are. Use this opportunity to learn more about maintaining a heart-healthy lifestyle. A few basic lifestyle changes could add years to your life and the lives of those you care about!
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NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
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