1. Introduction
1. Heart disease is the leading cause of death in people with diabetes.
2. Steps to control diabetes can also decrease your risk for heart disease.
3. It is never too late to make changes in your lifestyle to improve your health.

 
2. Development of heart disease in diabetes is related to
1. high blood sugar
2. high cholesterol &/or triglycerides
3. high blood pressure
4. physical inactivity
5. overweight

 
3. Macrovascular (large blood vessel) disease
1. Caused by atherosclerosis, the formation of plaque on the inside walls of the blood vessels, which reduces the amount of blood that can pass through.
2. Decreased blood supply causes damage to tissues and muscles through lack of oxygen and nutrition.
1. Heart – heart attack
2. Brain – stroke
3. Feet & legs – skin breakdown possibly leading to amputation

 
4. To prevent heart disease, determine your risk for heart disease and decrease those risk factors that you have the power to change (*). Risk increases with:
1. the longer that you have diabetes
2. growing older
3. family history of heart disease
4. *high blood sugar
5. *high cholesterol / triglycerides
6. *high blood pressure
7. *inactivity or lack of exercise
8. *overweight
9. *smoking
10. *stress

 
5. See your health care team regularly.
1. Blood tests

	how often	desired levels
Hemoglobin A1C	at least twice per year		shows how well blood sugar has been managed over the last 6-8 weeks.
Total cholesterol	at least once per year	less than 200
LDL’s (low density lipoproteins)	at least once per year	less than 100	"bad cholesterol", helps to form plaque in the blood vessels
HDL’s (high density lipoproteins)	at least once per year	men: more than 45 women: more than 55	"good cholesterol", helps to remove LDL’s from your blood
Triglycerides	at least once per year	less than 200	helps to form plaque in the blood vessels
Homocysteine	at least once per year		is linked to blood vessel damage and plaque buildup


 
2. Blood pressure – measures how hard the heart has to work to pump blood through the body; goal is to keep less than 130/85.
3. Self-monitoring between health care visits
1. blood sugars
2. cholesterol level kit
3. check your BP at home or local pharmacy
4. keep log of results and share with your health care team

 
6. Risk factor management – lifestyle changes
1. Achieve your target blood sugar goal
2. Good nutrition – consult with a dietitian re: healthy eating
1. choose foods high in fiber and low in fat
2. watch the carbohydrates
3. food preparation to decrease added fats, e.g. boiling or roasting instead of frying
4. control portion size
5. limit salt intake
3. Exercise more
1. consult with doctor before starting an exercise program
2. aerobic activities strengthen the heart, e.g. biking, dancing, swimming, walking
3. gradually increase your activity level
4. exercise 20 minutes or more, 3-5 minutes per week
5. start with warm-up, end with cool-down period
4. Stop smoking – consult with health care team
1. nicotine cravings can be controlled
2. family support is important
5. Stress management – consult with health care team if feel overwhelmed
1. set realistic goals for lifestyle changes
2. set aside relaxation time each day, hobbies
6. Medications

 
7. Know the symptoms of heart disease and heart attack
1. Heart disease
1. shortness of breath
2. weakness or tiredness
2. Heart attack
1. chest pain (angina)
2. chest pressure
3. neck, jaw or arm pain
4. sweating
5. nausea, vomiting
3. At first sign of heart attack, call 911 or have someone take you to the nearest emergency room and chew 2 aspirins.

MAKE HEALTH YOUR HABIT!

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