Apr 9, 2018
No doubt about it—diabetes on its own is a serious, life-threatening disease. Fortunately, it can be well managed with careful attention to diet, weight control, exercise, and medications that help stabilize blood sugar levels. Yet, despite all the positive news for people living with diabetes, diabetics have a greater risk for heart disease and stroke—even when blood sugar levels are under control. Especially individuals with type 2 diabetes.
“People who suffer from diabetes often have other conditions on top of their diabetes that contribute to heart disease,” says Queen Aimuyo, a family nurse practitioner with USMD Denton North Clinic. Aimuyo works with many of these individuals to help them control their diabetes and heart disease—and often both. “I try to create a compassionate environment that is nonjudgmental,” she says. “I always want them to feel that they can come talk to me.”
Aimuyo educates her patients about the four culprits that really boost the risk for heart disease in diabetics.
Culprit #1 – High Blood Pressure
When blood pressure is above heart healthy levels (less than 120/80 mm Hg), it means blood is pushed through the arteries with too much force. Over time, the excess force damages the walls of the arteries. Diabetes combined with high blood pressure doubles the risk for heart disease. “For these patients, losing weight, regular exercise, and a low-fat, low-cholesterol, low-sodium diet are really important,” Aimuyo explains.
Aimuyo helps her patients by encouraging them to keep a blood pressure log.
“Taking your blood pressure once at day at the same time each day and recording it in the log gives us a better picture than just one blood pressure reading. After logging their blood pressure for two weeks, I ask them to come back for a follow-up visit. If it’s still too high, I’ll start them on medication to help lower it—depending on what other medications they may be taking. There are several classes of blood pressure medications, and we may go through a period of trial and error to find the best one.”
Aimuyo may also prescribe a diuretic.
“The heart can become enlarged when blood pressure is not controlled,” she says. “Sometimes the fluid gets backed up and some people have swelling in their feet. A diuretic gets rid of this excess fluid and reduces the workload on the heart.
Culprit #2 – High cholesterol
Cholesterol is a waxy substance made by the body. It’s also found in some animal-based foods. Good cholesterol (HDL) is important to your overall health, but when bad cholesterol (LDL) is too high, it narrows and blocks arteries. “People with diabetes are more likely to have high levels of bad cholesterol which contributes to heart disease,” Aimuyo says.
Your care provider will advise you about the best target cholesterol level for you, but generally cholesterol levels (HDL + LDL) totaling less than 200 milligrams per deciliter (mg/dL) are considered good. Combined cholesterol levels between 200 and 239 mg/dL are considered borderline high, while 240 mg/dL and above is high. LDL cholesterol levels should be less than 100 mg/dL.
The best way to lower your cholesterol is to eat less saturated and trans fats. The American Heart Association recommends limiting saturated fat to just five to six percent of your daily calories. That means less red meat and dairy products made with whole milk. Skim milk, low-fat or fat-free dairy products are better choices. Avoid fried foods and sugary sweets and sodas. Fruits, vegetables, whole grains, poultry, fish and nuts should be on the daily menu. Eating this way will help you naturally increase your fiber intake, and a diet high in fiber can help lower cholesterol up to 10 percent.
Culprit #3 – Obesity
Obesity has been linked to insulin resistance—a major risk factor for cardiovascular disease. Insulin is a hormone that helps cells absorb glucose to fuel the body. When the cells can’t absorb it, a buildup of sugar circulates through the blood stream, damaging organs. With nearly 160 million Americans considered either obese or overweight, the floodgates are open for diabetes, heart disease, stroke, and many other diseases.
“Diet can be the biggest challenge for many patients,” Aimuyo admits. “But the right kind of diet—low sugar, low-fat, low cholesterol, low carbohydrate—will bring down blood sugar levels.”
Along with educating her patients about diet changes, Aimuyo asks them to keep food and blood sugar logs. “I have them take their blood sugar reading several times a day, every day,” she explains. “It’s important to check blood sugar an hour before food, two hours after eating, and at bedtime. Keeping a food diary also helps patients see how the foods they eat affect their blood sugar.”
Culprit #4 – Not Enough Physical Activity
We know we should move our bodies on a regular basis (every day, really), yet so many of us find a reason to skip it—and that is a sure way to shave years off your lifespan. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure, and reduce the risk for heart attack and stroke. You don’t have to be an athlete. Any type of moderate or vigorous aerobic activity will do the trick. Walking, playing sports, household work, gardening—they all deliver good benefits. Try for at least 30 minutes on most days of the week.
Aimuyo loves it when her patients start to see the benefits of healthy lifestyle changes. “It’s very rewarding because they see improvement and then they’re really motivated to keep it up. We’ve developed a trust and they see that we’re working together to help them enjoy a longer, healthier life.”
I’m here to help.”
If you need help managing diabetes, heart disease or both, family nurse practitioner Queen Aimuyou is here for you. Call 940-387-8763 to schedule an appointment.