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9 ways to protect your heart when diabetes threatens
it
Diabetes and heart disease were once thought to be entirely unrelated
disorders. New thinking suggests that they may actually spring from the
same underlying cause — chronic, systemwide inflammation — or
at least be influenced by it. This intertwining is a bad thing, since
developing diabetes usually means developing heart disease as well. It
also has a silver lining: Protecting yourself against one of these chronic
conditions works against the other, too.
More than one million Americans are diagnosed with type 2 diabetes each
year. Traditionally, up to 80% of people with diabetes develop some form
of cardiovascular disease, from heart attack and stroke to peripheral
artery disease and heart failure.
The connection between the two diseases isn’t ironclad. The American
Heart Association and the American Diabetes Association have joined forces
to fight both heart disease and diabetes. Their latest effort focuses
on helping people with diabetes whose hearts seem healthy keep them that
way.
As you scan the table below, notice that almost every recommendation
is good for diabetes as well as heart disease. The complete guidelines
are available at health.harvard.edu/112.
Strategy |
Goal |
Getting there |
Know your risk |
Knowledge is power. Calculate your
risk of heart disease, or ask your doctor to do it. |
The Framingham calculator is a general
heart disease–risk estimator. Specific ones for people with
diabetes have been developed by two diabetes groups. All are available
online at health.harvard.edu/113. |
Exercise |
Aim for at least 150 minutes a week
of moderate exercise (like walking) or 90 minutes of vigorous exercise. |
If you do just one thing on this list,
choose exercise. It is a key to controlling blood sugar, strengthens
the heart and lungs, improves blood pressure, corrects out-of-whack
cholesterol, and has other beneficial effects. |
Weight |
If your weight is in the healthy range,
work to keep it there. If you are overweight, try to lose 5%–7%
of your weight over the next 12 months. |
Cutting out just one 12-ounce can of
sugared soda a day (150 calories) is enough to help you lose a
pound a month. |
Diet |
- Cut back on unhealthy fats: Lower saturated fat and keep trans
fat intake as close to zero as possible.
- Add more unsaturated fats from fish, grains, and vegetable oils.
- Include at least 30 grams of fiber a day.
- Watch the salt — reduce your intake to under 2,500 milligrams
a day.
- Choose whole grains and other slowly digested carbohydrates.
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The foods you eat can help you control
blood sugar and protect your arteries. The main strategy is to
get more fruits, vegetables, beans, whole grains, fish, and vegetable
oils (especially olive oil), and less fast food, salty or fried
food, and rapidly digested carbohydrates. |
Blood pressure |
A healthy blood pressure is 120/80
or below. If you have high blood pressure, aim for a systolic pressure
of 130 or lower and a diastolic pressure of 80 or lower. |
Measure your blood pressure often;
home monitors are a good investment. |
Cholesterol |
Aim for these levels:
- LDL under 100 mg/dL
- HDL above 40 mg/dL
- Triglycerides under 150 mg/dL.
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A healthful diet and exercise can do
a lot to reverse risky lipid levels. A cholesterol-lowering statin
can help protect against heart attack and stroke even when LDL
levels are near the recommended goal. Niacin or a fibrate can improve
HDL and triglyceride levels. |
Smoking |
If you smoke, try to stop. Avoid secondhand
smoke whenever possible. |
The most effective quitting strategy
includes talk therapy plus nicotine replacement therapy along with
drugs such as bupropion (generic, Wellbutrin, Zyban) or varenicline
(Chantix). |
Blood sugar control |
Aim for hemoglobin A1c to be at least
under 7% and, ideally, as close to 6% as possible without causing
bouts of low blood sugar. |
Managing carbohydrate intake and switching
to whole grains can help ease the blood sugar roller coaster. Exercise
is vitally important. Use medications such as metformin, thiazolidinediones,
and insulin as needed. |
Antiplatelet agents |
Take a low-dose aspirin (75–162
milligrams) every day unless your doctor tells you not to. |
Aspirin prevents platelets from latching
onto each other, an early step in clot formation. Preventing clots
helps prevent heart attack and stroke. |
May 2007 update
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