Diabetics at higher risk for heart disease

When a person thinks about heart disease, diabetes does not often come to mind, too. But maybe it should.

“It’s very common for me to see patients with diabetes and heart disease,” says Dr. Margaret Fruhbauer, an internist with Advocate Condell Medical Center in Libertyville, Ill. “Unfortunately those are two illnesses that go hand in hand.”

Having diabetes or prediabetes puts a person at an increased risk for heart disease and stroke, according to the National Institutes of Health (NIH). A person with diabetes is at least twice as likely to have heart disease or stroke compared with someone who does not have diabetes, the NIH reports.

There are several reasons for the increased risks. People with diabetes, particularly type 2 diabetes, often have other conditions that contribute to their risk for developing cardiovascular disease. For example, they often have high blood pressure or unhealthy cholesterol levels, including high LDL (known as “bad” cholesterol), low HDL (known as “good” cholesterol), and high triglycerides.

“Diabetes accelerates a process called atherosclerosis, which is basically the depositing of layers of a waxy substance that’s made up of cholesterol, fats, calcium and other types of materials that develop a plaque inside the blood vessels,” says Dr. Fruhbauer. “This increases your risk for high blood pressure – often associated with diabetes – and also increases your risk for heart attacks as well as strokes.”

While the news may sound grim, there is hope, especially for people with prediabetes, she says. Prediabetes is a warning sign that diabetes may be imminent, says Dr. Fruhbauer, adding that about 50 percent of people with prediabetes will go on to develop diabetes within a five-year period. People with prediabetes should see it as a wake-up call.

“This is the time to take action before medications are required,” she says. “Lifestyle changes are essential.”

Among the changes Dr. Fruhbauer recommends: eating healthy, exercising and reducing stress.

Watch what you eat
When it comes to healthy eating, it is important to make the right choices. This includes reducing portion sizes, eliminating foods with significant amounts of sugar or sweeteners and increasing servings of fresh fruits and vegetable.

When making dietary recommendations to her patients, Dr. Fruhbauer often suggests the Mediterranean diet and “Dietary Approaches to Stop Hypertension,” also known as the DASH eating plan.

The Mediterranean diet emphasizes eating a plant based diet, healthy fats, olive oil and using herbs to flavor food.

DASH emphasizes portion size, eating a variety of foods and getting the right amount of nutrients and  encourages people to reduce sodium and eat foods rich in nutrients that may help lower blood pressure, such as potassium, calcium and magnesium. These include vegetables, fruits, whole grains, fish, beans and seeds.

“These are diets people can live with, and that’s important,” she says. “Choose a diet that can work with your lifestyle.”

Get up and go
As for physical activity, the American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise, or a combination of moderate and vigorous exercise. Thirty minutes a day, five times a week is the goal suggested by the association.

Dr. Fruhbauer suggests:

• Parking the car further away from the door when going to the grocery store or shopping center
• Taking the stairs instead of elevators
• Walking with a friend at work during a lunch break

“Different types of exercises keep you fit in different ways,” Dr. Fruhbauer says. “What’s important is that you do something.”

Pay attention to emotional well-being
While people may want to eat right and exercise more, sometimes life’s frustrations sabotage those good intentions. Work, family commitments and personal obligations mount, and healthy routines get squeezed out. Instead of getting sucked into the vortex, health experts say it’s OK to step back and slow down. The payoff comes not only in emotional benefits but physical ones as well.

“If we are not feeling good in our emotional life, our physical life is going to be suffering,” Dr. Fruhbauer says. “Try to make time for meditation and yoga. Those can calm the mind and help you choose healthier options when you’re under stress. They’re not a miracle cure-all, but they do help people quite a bit.”

Even 10 minutes a day can help with stress reduction. And most people can find 10 minutes in their day, she says.

Do you know your risk for heart disease? Take our heart risk assessment here. If you are at high risk, see one of Advocate Heart Institute’s cardiologists within 24 hours.