Reduce your risk of heart diseaseTuesday, 4 December 2018
Did you know that people with diabetes are two to four times more likely to develop heart disease or stroke than someone without diabetes – and at a younger age? Your risk is further elevated if you have a family history of heart disease or stroke. Accredited Exercise Physiologist Erin Freeman explains the link between diabetes and heart disease and the steps you can take to help protect your heart and manage your diabetes.
The link between diabetes and heart disease
The link between diabetes and heart disease starts with high blood glucose levels (BGLs). Over time, high BGLs will cause damage to arteries making them hard and stiff. We have more recently discovered that high BGLs also drive inflammation. These things increase the likelihood of atherosclerosis occurring (the build-up of fatty deposits known as plaque on the artery walls). Atherosclerosis restricts blood flow to vessels and organs throughout the body. Blockages to the heart and brain can cause heart attacks and strokes and this is the leading cause of death among people with diabetes.
Having diabetes itself is a major risk factor for heart disease and that is not surprising when you look at the risk factors for the two conditions. Diabetes and heart disease share many of the same risk factors such as smoking, high blood pressure, high cholesterol, physical inactivity and being overweight.
Reducing your risk factors
If you have diabetes and develop heart disease, lifestyle changes are the first step treatment. These lifestyle changes are very similar to those recommended to help manage your diabetes because as detailed above, the risk factors are pretty identical! Of course it’s possible to live many healthy years with both diabetes and heart disease, but the key to achieving optimal health is to ensure that your risk factors are under control. Good control of risk factors such as BGLs, cholesterol and blood pressure can reduce the risk of heart disease by 50% or more.
Steps you can take to help protect your heart and manage your diabetes
Be more active
Aerobic exercise is what helps the heart the most. Aim for at least 30 minutes of moderate intensity aerobic exercise on most, preferably all days. This type of exercise can help to decrease bad (LDL) cholesterol, increase good (HDL) cholesterol and reduce blood pressure.
Also incorporate at least two strength sessions per week as this in combination with aerobic exercise has the greatest impact on improving diabetes management and assisting with weight loss. Aim for 8-10 exercises targeting major muscle groups and complete 2-4 sets of 8-12 repetitions with good technique.
Make healthy food choices
Choose a wide variety of foods, including fruit, vegetables, wholegrains, lean meats and low-fat dairy foods. Include high-fibre, low glycemic index (GI) carbohydrate foods. To reduce your risk of heart disease, it’s also important to limit foods high in saturated fat and salt (sodium).
If you are above the healthy weight range, try to reduce weight
The recommended waist measurement is:
- less than 94cm for men
- less than 80cm for women
Losing as little as 5-10% of your weight (for example, 5-10kg for a 100kg person) can reduce your risk of heart disease.
Smokers who have diabetes have double the risk of heart disease! If you feel you can’t give up smoking on your own, ask for help – talk to your doctor or call the Quitline on 137 848.
Keep blood fats (cholesterol and triglycerides) within target range
As a guide aim for:
- Total cholesterol less than 4mmol/L
- LDL cholesterol less than 2mmol/L
- HDL cholesterol 1mmol/L or above
- Triglycerides less than 2mmol/L
Keep blood pressure levels within target range
High blood pressure is common in people with diabetes, and it can more than double the risk of heart disease. In general, people with diabetes should aim for:
- 130/80mmHg or less
However check with your doctor if you have existing heart or kidney disease for a more individualised target. Weight loss (if needed) and regular physical activity can help lower your blood pressure.
Keep blood glucose levels within target range
The HbA1c blood test reflects your average blood glucose level over the last 10 to 12 weeks. This should be done at least every 6-12 months, or more often if required. In general, aim for a HbA1c of:
- <7% or 53mmol/mol
Take medications as prescribed
Diabetes and heart disease are serious health conditions. If you have either of these conditions, your doctor may prescribe medication to help you manage. Some of these medications may target blood glucose levels, blood pressure or cholesterol. It’s important to take these medications as prescribed as skipping medications can cause negative health outcomes.