Know Diabetes By Heart – How To Keep Your Heart Healthy While Living With Diabetes

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PLEASE EXPLAIN THE JOINT PARTNERSHIP BETWEEN THE AMERICAN HEART ASSOCIATION AND THE AMERICAN DIABETES ASSOCIATION FOR THE “KNOW DIABETES BY HEART” INITIATIVE?

There are around 30 million Americans with diabetes, but only about half recognize their risk for heart disease. Last year, the American Heart Association and the American Diabetes Association launched a collaborative initiative called Know Diabetes by Heart to combat the public health impact of type 2 diabetes and heart disease. This collaboration is helping people with type 2 diabetes to better manage their health and reduce their heart disease and stroke risk factors.

 WHY IS HEART HEALTH MANAGEMENT SO IMPORTANT TO THOSE WITH TYPE 2 DIABETES?

Caring for one’s heart has an important role in diabetes management, especially since people living with diabetes are two times more likely to develop and die from heart disease. We’ve entered a new era of diabetes management where we recognize that treating not only diabetes, but also cardiac risk factors like cholesterol and blood pressure is important to the overall management of someone with diabetes.

WHAT ARE SOME RECENT TRANSFORMATIONS IN HOW PHYSICIANS THINK ABOUT AND TREAT DIABETES MANAGEMENT?

Research is showing us the benefit of focusing on heart and stroke risk factors in patients with diabetes. We’re transforming how diabetes is managed, which includes the need for cardiologists to be involved in that process. Know Diabetes by Heart supports health care providers in educating their patients living with type 2 diabetes on cardiovascular risk and increasing their patients’ engagement in prevention of heart disease through clinical tools and resources, as well as resources like the Know Diabetes by Heart Professional Education Podcast and Webinar Series.

WHAT IS THE ROLE OF A CARDIOLOGIST IN DIABETES MANAGEMENT?

As the incidence of diabetes continues to rise in the U.S., cardiologists are becoming an increasingly vital part of a patient’s diabetes care. The increased risk of heart disease that comes along with type 2 diabetes positions a cardiologist as an invaluable partner and expert in a patient’s journey.

 IF YOU HAVE TYPE 2 DIABETES ARE YOU MORE AT RISK OF HAVING HEART ISSUES?

Yes, people living with diabetes are two times more likely to develop and die from heart disease. Yet, research shows only about half recognize their risk or have discussed their risk for heart attacks or strokes with their health care providers.

 WHAT RESOURCES ARE AVAILABLE TO HELP PEOPLE LIVING WITH TYPE 2 DIABETES?

Know Diabetes by Heart is a great resource hub for those living with type 2 diabetes, providing quizzes, recipes, a doctor visit discussion guide with the top four questions to ask your doctor, as well as links to the American Diabetes Association’s Living With Type 2 Diabetes Program and their educational Ask the Experts Q&A Series. Learn more at www.KnowDiabetesByHeart.org/living-with-type-2/.

 IS IT POSSIBLE TO HAVE TYPE 2 DIABETES AND NOT HAVE HEART ISSUES?

Yes, but as stated above, people living with diabetes are twice as likely to develop heart disease. I encourage you to talk to your doctor at your next appointment about ways to reduce your risk for heart disease, even if you do not have existing issues now.

 WHAT IS THE LINK BETWEEN DIABETES AND CARDIOVASCULAR DISEASE?

The longer you live with type 2 diabetes, the higher your cardiovascular risk. Diabetes is associated with a buildup of plaque that can clog arteries, leading to a heart attack, stroke, heart failure or heart disease. People living with type 2 diabetes often have risk factors such as high blood pressure, unhealthy levels of cholesterol, cigarette smoking, obesity and lack of physical activity, which all contribute to their risk for developing heart disease.

ARE THERE NATURAL WAYS OF PREVENTING DIABETES AND HEART DISEASE?

Diabetes (and the related increased risk of heart disease) can be managed effectively through implementing lifestyle changes, such as an appropriate eating plan, losing weight, increasing your physical activity and properly managing stress. Talk to your doctor to see if medication is the right choice for you.

 WHERE CAN PEOPLE FIND OUT MORE INFORMATION?

Visit www.KnowDiabetesbyHeart.org for resources to help continue the conversation with loved ones and doctor. Additionally, schedule an appointment with your health care provider to talk about ways to reduce your risk for heart disease.

Dr. Lawrence answers your “Text Tom” questions below:

I have Graves disease (GD) and was treated with the radioactive iodine how does that affect diabetes or prediabetes?

When treating any chronic condition, doctors and patients work together to discuss and weigh risks and benefits of treatments. Radioactive iodine is used for treatment of GD. Radiation destroys living cells of the thyroid. However, radioactive iodine may also accumulate in the pancreas and this could lead to impaired glucose tolerance and diabetes mellitus. There are only limited studies, but radioactive iodine could predispose patients to glucose intolerance or even type 2 diabetes, I encourage you to speak with your doctor about these treatment decisions.

Regarding diabetes, what does metformin do? Side effects are making it undesirable.

In the absence of contraindications, metformin and lifestyle interventions are considered the initial treatments of choice for high blood sugar in type 2 diabetes. Metformin’s major effect is to decrease glucose (a sugar) output from the liver. It also increases insulin-controlled use of glucose in the body’s tissues. This decrease in production of “sugar” and more efficient use of “sugar” by the body’s tissues, leads to lower “blood sugar” levels.

The most common side effects of metformin are gastrointestinal such as nausea, abdominal discomfort, and diarrhea. Talk to your health care provider about these side effects and discuss the best next steps given your medical history.

I don’t have diabetes….yet there is family history. I smoke a pack a day. Will that put me at risk for heart disease?

Yes. Type 2 diabetes has a stronger link to family history and lineage than type 1 diabetes, and it is also dependent on environmental factors and lifestyle choices (such as smoking). Latinos/Hispanics and African American populations are especially vulnerable to diabetes and its complications due to genetic factors, as well as non-medical issues that can contribute to this problem (such as disparities in income, education and access to healthcare).

Genetic factors can also play a role in developing heart disease, and the risk is heightened when combined with unhealthy habits and behaviors like smoking.

I would encourage you to visit www.heart.org/quitsmoking for resources to help you quit smoking.

 

Willie Edward Lawrence Jr., MD, FAHA, FACC is Chief of Cardiology at Research Medical Center in Kansas City, Missouri.  He is a native of Cleveland, Ohio. He is a High Honors graduate of Phillips Exeter Academy in Exeter, NH. He earned his B.A. in Biology from Harvard College and M.D. from Harvard Medical School. He received his Internal Medicine training at Harvard’s Brigham and Women’s Hospital.

Dr. Lawrence is a member of the Association of Black Cardiologists. 

He is the father of three, Xavier, Westbrook, and MacKenzie, and is married to Sandra A. J. Lawrence.

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