IN THIS ISSUE

From the Fall 2004 Issue

Cardiovascular News

Heart Disease and Diabetes—What's the Connection?

"In the last three decades alone, the number of people with diabetes has tripled," according to Tommy Thompson, former Secretary of Health and Human Services.

That's an amazing increase. But what does it have to do with heart disease? More than you might think: two out of three people with diabetes die from heart disease or blood vessel disease, like stroke. That's 13 million of the more than 20 million Americans who now have diabetes.1

Many more have pre-diabetes (see box). And researchers say that if obesity rates continue, the incidence of diabetes worldwide will double in another 25 years.2

As recently as 10 or 20 years ago the link between diabetes and heart disease wasn't clearly understood. Now that doctors and researchers know just how serious heart disease is for people with diabetes, they are trying to get the word out to the public.

This big jump in the number of people with diabetes may also mean a big increase in the potential for heart disease.

What Is Diabetes?

Diabetes is a disease involving insulin, a natural hormone in the body. Insulin allows blood sugar, called glucose, to enter your body's cells and be used for energy. The sugar or glucose can't enter cells without insulin's help. If the glucose remains in your blood, it can build to toxic levels. There are two types of diabetes:

Type 1 Diabetes—Your pancreas isn't able to produce enough insulin. Insulin has to be delivered by a pump or an injection. Type 1 diabetes is less common than type 2. Just 5-10% of people with diabetes have type 1.1

Type 2 Diabetes—Your cells can't respond properly to insulin. This form accounts for 90-95% of people with diabetes, and it is on the rise.1 And it is increasingly being diagnosed in adolescents, pointing to our unhealthy lifestyle choices:

• Too little exercise
• Being overweight
• Eating and drinking too many foods and beverages high in fat and/or sugar, which lead to weight gain

Why All the Concern About Diabetes?

Diabetes is such a serious illness because it can lead to a number of medical problems:

• Heart disease and stroke
• Blindness—Diabetes is the leading cause of new cases of blindness in adults
• Kidney disease (also called renal disease)—Diabetes is the leading cause of life-threatening renal disease
• Nerve disease (pain or lack of sensation in the feet or hands) as well as amputations
• Gum disease and tooth loss

There is no cure for diabetes, but it can be controlled through:

• Diet
• Exercise
• Medications

Why Should People with Diabetes Be Concerned About Heart Disease?

It's true that anyone can develop heart disease—you don't have to have diabetes first. But the more risk factors you have for heart disease, the more likely you'll develop it. And your chance of developing heart disease or stroke is more than twice as high if you already have diabetes.1

People with diabetes are two to four times more likely to die of heart disease than the general public. In fact, heart disease is the leading cause of death for people with diabetes.4

How Could Diabetes Lead to Heart Disease?

Diabetes affects the heart by affecting the cholesterol (fatty substances) in your blood. The disease changes the balance of good and bad cholesterol, leading to higher levels of the bad cholesterol (called LDL). (See The Basics About Cholesterol Testing.)

As the bad cholesterol increases, plaque can build up in your arteries. Plaque buildup can cause arteries to become narrow, leading to cardiovascular problems, including:

• Heart attack—A blood clot in a narrowed artery cuts off blood supply to the heart
• Stroke—A blood clot in a narrowed artery cuts off blood supply to the brain

Positive Steps You Can Take

The following lifestyle changes can help you avoid developing heart disease and diabetes:

• Maintain a healthy weight
• Eat a healthy diet that ../includes:
• Low-fat foods
• Lots of fruits and vegetables
• High-fiber foods like beans, brown rice, and oatmeal
• Foods low in salt
• Foods low in added sugar
• Get regular exercise (30 to 60 minutes most days of the week)

In fact, a nutritious diet and moderate exercise can reduce the risk of developing adult diabetes by 58%.5

Talk to Your Doctor

Along with adopting a healthy lifestyle, you should check with your doctor to get advice about:

• What type of exercise and diet are right for you
• Whether you should be taking medication
• Whether you have a family history of heart disease and diabetes
• The need for routine tests or screenings to check your cholesterol, blood pressure, and blood sugar levels

Be proactive—take steps to make your lifestyle healthier. It benefits you—and therefore it also benefits those who care about you.

1. American Diabetes Association. 2004.
2. Wild S. Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-1053.
3. National Institutes of Health. Announcement, April 29, 2004.
4. US Food and Drug Administration. Diabetes Information.
5. Tuomilehto J, Lindström J, Eriksson J, et al. Prevention of type 2 diabetes by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine. 2001;344:1343-1350.

Note: Individual symptoms, situations, and circumstances may vary. Please consult your physician or qualified health provider regarding your condition and appropriate medical treatment. The information provided is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice.

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