Diabetes and Heart

Preventing Diabetes Problems: Keep Your Heart and Blood Vessels Healthy

 Mellitus diabetes presents many secondary health problems, which need to be carefully managed to stay healthy when diabetes has developed. This article is the first in a series that will look at manageing health for diabetes patients. 

High blood glucose can cause heart and blood vessel problems.  Let’s take a look at what the heart and blood vessels do and at measures that will help to keep them healthy.

What do my heart and blood vessels do?

Your Heart

Your heart and blood vessels make up your circulatory system, which carries oxygen and nutrients all around the body, and takes waste products away for excretion. Your heart is a musclular organ that pumps blood through your body. It pumps blood to large blood vessels, called arteries, which feed into smaller blood vessels, called capillaries. These get finer and finer as they branch and make their way through all the tissues of the body.  Blood vessels then merge together again (now called veins) as they move blood away from the tissues and back to the heart & lungs to refresh the blood with oxygen; and send it back around the body.
 

What can I do to prevent heart disease and stroke?

With diabetes, there’s a greater risk of heart disease and strokes; but we can do a lot to prevent both heart disease and stroke.  Here are some of the self-help measures we can take:

• Keep your blood glucose under control. You can see if it is under control by having an A1C test at least twice a year. The A1C test tells you your average blood glucose for the past 2 to 3 months. The target for most people is below 7.
• Keep your blood pressure under control. Have it checked at every doctor visit. The target for most people is below 130/80.
• Keep your cholesterol under control. Have it checked at least once a year. The targets for most people are:
  - LDL (bad) cholesterol: below 100 – HDL (good) cholesterol: above 40 in men and above 50 in women
  - triglycerides (another type of fat in the blood): below 150
• Make physical activity a part of your daily routine. Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you.  There are lots of ways to incorporate exercise into daily routines:
   Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the parking lot.
• Make sure that the foods you eat are “heart healthy.” That means they should include foods high in fibre, such as oat bran, oatmeal, whole-grain breads and cereals, fruits, and vegetables.
• Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil.
• Limit foods with trans fat, such as snack foods and commercial baked goods.
• Lose weight if you need to. If you are overweight, it’s another risk factor added to your diabetes, so try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.

• If you smoke, quit!

  

  Quit Smoking

  Your doctor can tell you about ways to help you quit smoking.

• Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
• Take your medicines as directed.

How do my blood vessels get clogged?

Blood cholestrol levels are the main concern here. Several things, including having diabetes, can make your blood cholesterol level too high. It’s important to remember that Cholesterol isn’t “all bad”.  It is a substance that is made by the body and used for many important functions.  We take it in through food derived from animals.

When cholesterol is too high, the insides of large blood vessels become narrowed or clogged. This problem is called atherosclerosis. Narrowed and clogged blood vessels make it harder for enough blood to get to all parts of your body; and that condition can cause problems.
 

What can happen when blood vessels are clogged?

When blood vessels become narrowed and clogged, you can have serious health problems:

• Chest pain, also called angina.  It is a warning that the heart and blood vessels are under stress. When you have angina, you feel pain in your chest, arms, shoulders, or back. You may feel the pain more when your heart beats faster, such as when you exercise. The pain may go away when you rest. You also may feel very weak and sweaty. If you do not get treatment, chest pain may happen more often. If diabetes has damaged the heart nerves, you may not feel the chest pain: which is a serious concern, you need to know if your heart is under stress!.
• Heart attack. A heart attack happens when a blood vessel in or near the heart becomes blocked. Not enough blood can get to that part of the heart muscle. When an area of the heart muscle stops working, the heart becomes weaker. During a heart attack, you may have chest pain along with nausea, indigestion, extreme weakness, and sweating.
• Stroke. A stroke can happen when the blood supply to the brain is blocked. Then the brain can be damaged from lack of oxygen.

What are the warning signs of a heart attack?

You may have one or more of the following warning signs:

•  chest pain or discomfort
• pain or discomfort in your arms, back, jaw, or neck
• indigestion or stomach pain
• shortness of breath
• sweating
• nausea
• light-headedness

          Or, you may have no warning signs at all.

Warning signs may come and go. If you have any of these warning signs, call 911 (Emergency) right away.

How do narrowed blood vessels cause high blood pressure?

Narrowed blood vessels leave a smaller opening for blood to flow through.  It creates pressure, just like turning on a garden hose and holding your thumb over the opening. The smaller opening makes the water shoot out with more pressure. In the same way, narrowed blood vessels lead to high blood pressure. Other factors, such as kidney problems and being overweight, also can also lead to high blood pressure.

Healthy and Diseased Blood Vessels

Many people with diabetes also have high blood pressure. If you have heart, eye, or kidney problems from diabetes, high blood pressure can make them worse.
 
You may have seen your blood pressure written with two numbers separated by a slash. For example, your reading might be 120/70, said as “120 over 70.” For people with diabetes, the target is to keep the first number below 130 and the second number below 80.

If you have high blood pressure, ask your doctor how to lower it. Your doctor may ask you to take a daily blood pressure medication. Some types of blood pressure medicine can also help keep your kidneys healthy.

You may also be able to control your blood pressure by:

• eating more fruits and vegetables
• eating less salt and high-sodium foods
• losing weight if you need to
• being physically active
•  not smoking
•  limiting alcoholic drinks

What are the warning signs of a stroke?

A stroke is the sudden death of some brain cells due to a lack of oxygen. It happens when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain.

Depending on the part of the brain that is damaged, a stroke can cause:

• sudden weakness or numbness of your face, arm, or leg on one side of your body
• sudden confusion, trouble talking, or trouble understanding
• sudden dizziness, loss of balance, or trouble walking
• sudden trouble seeing in one or both eyes or sudden double vision
• sudden severe headache

Sometimes, one or more of these warning signs may happen and then disappear. You might be having a “mini-stroke,” also called a TIA (transient ischemic attack). If you have any of the warning signs, call 911  (Emergency)  right away.

How can clogged blood vessels hurt my legs and feet?

PAD – Peripheral arterial disease – can happen when your blood vessels become narrow and your legs and feet don’t get enough blood. Signs of this are that you may feel pain in your legs when you walk or exercise. Some people also have numbness or tingling in their feet or legs or have sores that heal slowly.

Circulation & PAD

What can I do to prevent or control PAD?

• Don’t smoke.
• Keep blood glucose and blood pressure under control.
• Keep blood fats close to normal.
• Exercise.
• Ask your doctor if you should take aspirin every day.

          In some cases, you also may need surgery to treat this problem.

To summarize

There are a few circulatory problems that can arise or be made worse due to diabetes.  They present some clear signs due to trauma, such as pain in the chest and limbs. They are caused by a degeneration of our circulatory system, the health of the heart muscle and the condition of the blood vessels.  There are a number of basic lifestyle measures that we can take that will help prevent or alleviate these problems.  For most of the circulatory problems this essentially means: avoiding smoking and junk foods; doing more exercise (add walking back into your routines!) and eating a healthy diet that includes more fruit & vegetables and less high calorie and animal foods. 

Your health is a great return on investment in these measures!