Maxy sez : Have Diabetes? Protect Your Heart

By Om P. Ganda, MD, Special to Everyday Health

If you have diabetes, heart disease can be a serious concern. The good news is there are steps you can take to reduce your risk for cardiovascular disease. Here are seven tips I share with my patients.

1. Control Your Weight
Being overweight or obese increases your risk for heart disease, and if you have diabetes, then you are at an even higher risk for cardiovascular complications. One of the most important things you can do to prevent these complications is to maintain a healthy weight. If you are overweight, talk to a registered dietitian about healthy ways to lose weight.

2. Get Regular Physical Activity
The American Heart Association (AHA ) and the American Diabetes Association (ADA) recommend a minimum of 30 minutes of daily exercise, such as going for a walk, at least five days per week. To begin incorporating physical activity into your routine, build a plan that works well for you and meets your needs. If you don’t have 30 continuous minutes for exercise, try integrating 10 to 15 minute intervals of physical activity into your schedule, which research shows is just as effective.

3. Don’t Smoke
If you already smoke, then make plans to begin a smoking cessation program. Nicotine narrows and restricts blood vessels; diabetes will do the same thing, effectively doubling the negative effects to your vascular system. Remember — while you can’t change having diabetes, you can stop damage caused by nicotine.

4. Maintain Good Glucose Control
Good control of your blood glucose levels can prevent many complications from diabetes, including the damage high blood glucose can do to your blood vessels. To protect your heart, try aiming for an A1C reading of less than 7 percent, or as advised by your healthcare provider. At Joslin, we recommend eating fiber-rich foods, such as fruits, vegetables, and whole grains to help you achieve this goal.

5. Lower Your LDL ‘Bad’ Cholesterol
The ADA recommends an LDL cholesterol goal of less than 100 mg/dl, and your LDL levels should be even lower if you have heart disease, or are at high risk for heart disease. In addition to a healthy diet plan, most people with diabetes need to take a statin pill to further reduce their risk for heart disease. If you have high triglycerides, it can be beneficial to incorporate fish into your diet. Be sure to ask your health care provider about omega-3 fish oil supplements.

6. Control Your Blood Pressure
People with diabetes should aim for a blood pressure reading of less than 140/90, according to recently revised guidelines by the Eighth Joint National Committee (JNC 8). These new guidelines have also been adopted by the ADA. At Joslin, we suggest an even lower blood pressure reading of 130/80 in younger people, or if you have any indication of kidney disease. Reducing your salt intake and starting a healthy diet program should be part of your treatment program, as well as taking any medications as advised by your healthcare provider.

7. Consider Taking a Daily Aspirin
The ADA recommends a low dose (81-162 mg) aspirin daily for everyone with heart disease. Also, most men age 50 and women age 60 or older may need a low-dose aspirin daily.

While the risk of developing heart disease as a diabetes-related complication can be frightening, following these seven tips will significantly decrease your risk for developing cardiovascular disease in addition to improving your overall health.

Om P. Ganda, MD, has been engaged in clinical diabetes research for more than three decades. He directs the Lipid Center at Joslin Diabetes Center in Boston, where he treats patients with complex issues related to elevated cholesterol and triglycerides. He is also studying why patients with type 2 diabetes have increased susceptibility to elevated cholesterol and heart disease. He serves as a co-investigator on several ongoing clinical trials to identify better ways to treat people who have difficulty with exercise and diet control. Dr. Ganda is also an Associate Professor of Medicine at Harvard Medical School.