Welcome to DIY (Do It Yourself) Diabetes with Marci Page Sloane

Diabetes & Heart Disease
Take steps to avoid developing this serious and common diabetes complication

One of the most common and serious complications of diabetes is heart disease. Diabetes is a disease of the vessels. High blood sugar damages your blood vessels by building a plaque which leads to clogged arteries or atherosclerosis. More than 65% of deaths in diabetes are due to heart disease. In fact, when you have diabetes, you're 2-4 times more likely to have a heart attack or stroke, you’re more likely to die from a heart attack, complications from heart disease results at an earlier age, and your risk of sudden death from a heart attack is the same as for someone who has already had a heart attack.

The good news is that even after your diabetes diagnosis you have the power to prevent heart disease.

Here’s how:

  • Manage your blood sugar (Read "12-Steps to Controlling Your Diabetes")
  • Keep your blood pressure lower than 130/80
  • Control cholesterol and triglycerides, making sure your HDL (healthy cholesterol) is at least 50 mg/dL for women and 40 mg/dL for men and your LDL (lousy cholesterol) is under 100 mg/dL or even lower than 70 mg/dL if you have other heart disease risk factors and take cholesterol-lowering medication. Triglycerides should be under 150 mg/dL.
  • Stay active
  • Stop smoking
  • Maintain a healthy weight
  • Use alcohol moderately
  • Eat healthier

What's a heart healthy way to eat?

  • Avoid over-consumption of saturated-fat foods (cheese, meat, high-fat/whole-fat dairy products, sauces, gravies, butter, and some low carbohydrate foods) and foods containing trans fat (mostly in processed foods with partially hydrogenated oils). These fats clog your arteries and encourage your liver to produce extra, more harmful cholesterol. 15-20 grams of saturated fat and trans fat combined for the day should be the maximum amount you consume. Consume mostly monounsaturated-fat foods (olive oil, nuts, avocado). These fats increase healthy cholesterol and decrease unhealthy cholesterol levels.
  • Eat high-fiber foods (at least four or five grams per serving) to total 30-50 grams each day. Build your fiber intake up gradually. Look for fiber in cereal (beware of the sugar!), grains (kasha, barley, millet), fruits, vegetables, and beans.
  • Consume cold-water fish that is high in omega-3 fats. This includes salmon, tuna, sardines, and mackerel. These omega-3 fats are found to thin the blood (therefore reducing clot formation and possibly a heart attack or stroke), boost good cholesterol and lower triglycerides. Fish is also an excellent replacement for higher-saturated-fat foods such as meat or poultry. You may also take up to 3,000 mg of fish oil daily. Always check with your doctor first.
  • Take a multivitamin or a B-complex supplement.
  • Consume foods with flavonoids, an antioxidant found in red grapes, blueberries, red wine, onions, citrus fruits, tomatoes, and black and green tea. Flavonoids thin blood and prevent damage from cholesterol.
  • Antioxidants like vitamin C, E, selenium and beta-carotene reduce free radical damage. Free radical damage may promote heart disease by stimulating blood to clot and plaque to build in the arteries. Free radicals are produced when oxygen is broken down by radiation exposure, air pollution, ozone, cigarette or cigar smoke, rancid fats or by-products of our foods and medications. They then allow disease to begin in our bodies. Oxidation in our bodies is similar to a rusted iron pipe. When a pipe is exposed to oxygen over time, it will rust. This rust is similar to the plaque buildup in our arteries. Antioxidants (anti-oxygen or against oxygen) do not allow oxygen to be broken down, so they neutralize these free radicals so they don’t lead to diseases such as heart disease, cancer, arthritis, and aging by damaging the cells. Eating foods rich in whole grains, fruits, and vegetables is preferable in addition to taking vitamin C, E, beta-carotene and selenium supplements.
  • Vitamin C (250-500 mg per day) or consume peppers, citrus fruits, broccoli, Brussels sprouts, cauliflower.
  • Vitamin E (400 IU per day as d-mixed-tocopherols) or consume vegetable oils, almonds, soybeans, wheat germ, sunflower seeds.
  • Beta-carotene (5,000-10,000 mg per day) or consume orange fruits and vegetables, dark leafy green vegetables, sweet potatoes, carrots, dried apricots, collard greens, spinach, kale.
  • Selenium (100–200 mcg per day) or consume Brazil nuts, grains, seafood.
  • Selenium and vitamin E taken together with a meal with some fat increases absorption in the body. Take apart from vitamin C, which may hinder absorption.
  • Coffee: If it’s brewed in French press machines, unfiltered or served as espresso, coffee maintains two compounds that may raise cholesterol. Cafestol and kahweol tend to raise LDL (lousy) cholesterol levels. Filtered coffee has not been shown to have these effects.
  • Garlic has antioxidant properties. Onions, shallots and leeks, like garlic, are from the allium family and contain compounds to help prevent heart disease.
  • Avoid over-consumption of animal protein. Most of us need only six to ten ounces of protein a day. Americans easily consume 15-20 ounces or more daily. Most of the protein we consume comes from meat or poultry that contain the highest amounts of saturated fat and cholesterol. Substitute fish or soy products when possible, or combine beans and grains for a complete protein (please count the carbohydrates!)
  • Beware of fat-free foods. They usually contain more carbohydrates (sugar) and/or sodium. Excess sugar or carbohydrates turn into fat (triglycerides) since they can't be stored in abundance in the body. Choose low-fat food instead.
  • Shellfish is a good choice. It has slightly higher amounts of sodium, but it has virtually no saturated fat! Shrimp and crayfish have higher levels of cholesterol than other shellfish. When compared to meat or poultry that do contain saturated fat, however, even the shrimp and crayfish come out on top. When you weigh out the portions typically eaten of shrimp vs. meat the cholesterol is identical. There is still the saturated fat issue, however. Remember that saturated fat raises your cholesterol. Scallops have minimal cholesterol and are an even better choice.
  • Sodium needs to be consumed in lower amounts. It may contribute to high blood pressure. A low sodium food has 140 mg per serving and a low sodium daily budget should be under 2,000 mg.
  • Excess body weight certainly may contribute to heart disease, especially if stored in the chest and abdomen (apple shape).
  • Ask your doctor for the following blood tests to predict your heart disease risk: C-reactive protein, homocysteine, triglycerides, cholesterol (HDL/LDL), glucose, HbA1c and blood pressure.
  • Consume diabetes and heart healthy snacks like fruit and nut butter or low-fat cheese or yogurt and nuts.
  • Consume diabetes and heart healthy meals that emphasize non-starchy vegetables like broccoli, green beans, spinach, tomatoes, have moderate amounts of grains like quinoa, barley, kasha, and incorporate fish with high levels of omega 3 fats like wild salmon. Focus on adding many colors and dark colors of foods for a variety of nutrients in your meals and snacks.

Here's to your good heart health!

Marci Sloane, MS, RD, LD/N, CDE, is a registered and licensed dietitian/nutritionist and certified diabetes educator with a degree in Nutrition and Physiology from Teachers College at Columbia University. Marci is the author of The Diet Game: Playing for Life! More about Marci Sloane

The goal of Destination Diabetes is to be a useful and credible resource for the more than 20 million children and adults who have diabetes in the U.S. and their families. Destination Diabetes provides information on a wide range of diabetes health and wellness topics. Articles are written or reviewed by diabetes advisors who have experience in diabetes education.