SPRINGFIELD — There is an ad currently running on television about a type 2 diabetes pill that asks people on the street if they know that having type 2 diabetes more than doubles one’s chance of dying from a cardiovascular event such as a heart attack or stroke. One woman, whose husband has diabetes, looks at him and says, “that can’t be true, can it?”
The answer — cardiovascular disease is the number-one cause of death for adults with type 2 diabetes and heart disease.
When it comes to risk factors for heart disease, said Dr. Quinn Pack, a preventive cardiologist in the Heart & Vascular Program at Baystate Medical Center, there are six ‘big ones’ to control — high cholesterol, uncontrolled blood-pressure problems, diabetes, physical inactivity, smoking, and obesity.
“Diabetes is completely linked at the hip with obesity and is number three on my list of risk factors to control in the fight against heart disease. It can be easily diagnosed, and there are good medications available to control your blood sugars,” Pack said. “Unfortunately, with the current obesity epidemic, the number of people in the United States with diabetes is rapidly increasing. For years, the rate of heart disease was decreasing, but we’ve seen an increase of heart disease in the past five years. Most scientists think the ‘diabesity’ epidemic is the main reason for the increase in heart disease.”
Diabetes is a disease in which the body’s blood glucose (sugar) level is too high. Normally, the body breaks down food into glucose and carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy. The two main types of diabetes are type 1 and type 2. In type 1 diabetes, the body doesn’t make enough insulin, which causes the body’s blood-sugar level to rise. In type 2 diabetes, the body’s cells don’t use insulin properly as part of a condition called insulin resistance. Initially, the body reacts by making more insulin, but eventually can’t make enough insulin to control its blood-sugar level.
February is American Heart Month, an ideal time to work closely with your physician to modify your risk factors through lifestyle changes, and, when those aren’t enough, by taking medications — statins for high cholesterol, ACE inhibitors, beta blockers, and others for high blood pressure — prescribed by your doctor to help control your risks.
Charting a course for good heart health begins with a visit to your primary-care physician, who can assess your individual risk factors and then tailor a strategy for you to follow. Your doctor will want to take a thorough medical history and complete a physical exam, as well as screen for high blood pressure and high cholesterol, which can damage your heart and blood vessels. Since diabetes is a risk factor for developing heart disease, your doctor may also prescribe a fasting blood-sugar test to check for the disease. Also, an electrocardiogram, or EKG, as most people know it, might be done to establish a baseline and to check your heart health if other diseases or conditions, such as diabetes or high blood pressure, are present. If your blood sugars are running high, your doctor may also refer you to an endocrinologist for treatment of type 2 diabetes.
Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart problems such as coronary artery disease, heart failure, or stroke.
“That’s why it is so important to lower your blood glucose levels and keep them under control,” said Dr. Chelsea Gordner, an adult and pediatric endocrinologist at Baystate Medical Center and Baystate Children’s Hospital. “The good news is that you have the power within you to control your diabetes beginning with some simple lifestyle changes, such as losing weight, exercising, and eating a healthy diet. But sometimes that is not enough, and your doctor may need to prescribe oral medications or insulin to help control your blood glucose levels. There are many medications available to treat diabetes, some of which can lower your risk of future cardiovascular events.”