Helping People With Type 2 Diabetes Control CVD Risk
Diabetes occurs when our bodies fail to use blood sugar (glucose) effectively. Type 2 diabetes is the most common form, accounting for up to 95 percent of diagnosed cases in adults. Cardiovascular disease (CVD) is the most common cause of death among adults with diabetes.
Live Your Best Lifestyle
Lifestyle factors are key to managing CVD risk in those with diabetes. Proper nutrition, physical activity and weight management are the basics, as usual.
The types of exercise may be as important as the amount of exercise in diabetes. A randomized, controlled trial of 262 sedentary people with diabetes demonstrated that those who combined resistance and aerobic training had lower glucose measurements than others who either didn’t exercise, did only resistance training or only aerobic training.
Fruits and vegetables, low-fat dairy and reduced saturated fat should be emphasized for those with diabetes. Individualized medical nutritional therapy that focuses on calories and carbohydrates is also recommended. There is evidence that the DASH, Mediterranean, low-fat or modified-carbohydrate diets were effective in controlling blood sugar and lowering CVD risk. People with diabetes often have trouble with higher triglycerides (fats in the blood) and lower HDL (good) cholesterol. As a result, they should limit alcohol, eat less saturated and trans fats and eat less added sugar.
Practicing the dietary and physical activity recommendations is the best way to achieve a healthy weight. Restricting calories and increasing daily physical activity, including regular aerobic activity three to five days a week, are practical and proven steps to losing pounds. There is also evidence that self-monitoring by weighing more often is associated with better weight loss and maintenance.
High blood pressure increases the risk of heart attack, stroke, heart failure, kidney failure and eye problems. It is recommended that most people with diabetes maintain a blood pressure of less than 140/90 mm Hg. Following the lifestyle recommendations for nutrition and physical activity may help keep blood pressure under control. The American Heart Association recommends a daily sodium intake of no more than 1,500 mg as well.
Lowering LDL (bad) cholesterol decreases CVD risk in diabetes patients. People with diabetes should have their cholesterol checked at least once a year. Lifestyle changes — eating less saturated and trans fat, losing weight, eating more dietary fiber and being active — are recommended. These lifestyle changes, especially weight reduction, have been shown to improve most components of the cholesterol profile in diabetes patients.
It is recommended that all patients between 40 and 75 with diabetes and LDL-C levels between 70 and 189 mg/dL should be treated with a statin.
Blood Sugar Control
Though important for other reasons, blood glucose control itself provides only a modest reduction in major CVD outcomes and no significant effect on death rates. Treating other risk factors resulted in greater benefits to CVD risk for diabetes patients.
Excerpted and adapted from Controlling Your Risk When You Have Diabetes, from Heart Insight Spring 2016.