Diabetes and Your Heart

with Rajeev Jain, M.D., Endocrinologist, Advanced Healthcare

Posted: Nov. 1, 2004

Are you managing your diabetes effectively? That’s a question you must take seriously.

“I don’t know how to say this lightly,” said Rajeev Jain, M.D. “If you are a diabetic, you are at high risk of getting heart disease. Two out of three people with diabetes die from heart disease and strokes.”

For diabetics, high blood pressure, and/or elevated levels of cholesterol and triglycerides, along with smoking and being obese, are serious problems, according to Dr. Jain, a specialist in diabetes at Advanced Healthcare. “All these factors increase the risk of heart disease significantly in anyone, but have a much more major impact on the diabetic population,” he said.

Rajeev Jain, M.D., Endocrinologist, Advanced Healthcare "If you are a diabetic, you are at high risk of getting heart disease. Two out of three people with diabetes die from heart disease and strokes."

“Knowing this, the primary medical focus in the management of diabetes has shifted to reducing the risk of heart disease. We believe that we must be very aggressive in controlling blood pressure, weight and cholesterol levels in the diabetic population.”

What is the role of blood glucose?
Dr. Jain explained that diabetics have high blood glucose because of problems in converting glucose to energy. After a meal is eaten, food is normally broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use insulin, a hormone made in the pancreas, to help them process blood glucose into energy, but in type 1 diabetes (usually contracted by younger individuals), the body destroys insulin producing cells in the pancreas, resulting in the inability to produce insulin.

In type 2 diabetes, which generally affects older individuals who are significantly overweight, the body does not respond to insulin as efficiently as in normal people. Eventually, the pancreas cannot make enough insulin for the body’s needs. As a result, the amount of glucose in the blood increases while the cells are starved of energy.

Type 1 patients require insulin for survival. Type 2 patients don’t necessarily need insulin for survival, but may require it for control. There are excellent drugs that successfully treat the disease, but those diabetics who are obese must work hard at losing weight in order to respond well to those oral medications.

Over time, high blood glucose may damage nerves and blood vessels, leading to complications such as heart disease, blindness, stroke, kidney disease, nerve problems and amputation.

Symptoms and treatment
Symptoms of type 2 diabetes include increased thirst, increased hunger, fatigue, increased urination — especially at night, unintended weight loss, blurred vision and sores that do not heal. But these symptoms can be so mild that one might not even notice them, and many people experience no symptoms at all.

“In order to fight the disease, the standard of care in patients and those at risk of developing it includes taking one aspirin every day to reduce the risk of heart disease,” said Dr. Jain. “That’s not to underplay the importance of blood sugar control, which is another vital factor in the management of diabetes.”

Physical activity is part of diabetes management too. “Regular exercise is also important. It provides not only weight control but also improved cardiovascular fitness,” Dr. Jain said. “We recommend a minimum of walking one-half hour a day, five days a week. That’s the simplest way of doing it. Because the risk of heart trouble is so high, a diabetic who wants to do more than just walking should first consult with a physician.

“And a diet low in saturated fats and cholesterol can help. These are also major issues for both pre-diabetic and diabetic populations,” he said.

“We’re now seeing obesity and a much higher incidence of type 2 diabetes in teenagers. So the pendulum seems to be swinging in that direction. It stands to reason that weight control is vitally important,” he observed.

According to Dr. Jain, diabetics should be proactive in their own management of the disease. “They need to check their blood sugar regularly. They should know what their cholesterol and blood pressure levels are. They should quit smoking, of course. And they should ask their doctors what they can do to improve things,” he said. “It’s important to be an empowered and educated patient to know and understand your risk factors — and what to do to alleviate them. It’s really a partnership between the doctor and the patient.”

For information on diabetes education classes at Advanced Healthcare, call 888-709-2080 or 262-512-2880.

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