The diabetes/heart disease risk: How to keep it from claiming you

Having type 2 diabetes is like having a heart attack. The same things -- high cholesterol, high blood pressure, insulin resistance, physical inactivity and obesity -- can cause both.

In fact, if you have diabetes you're two to four times more likely to die of heart disease or stroke than most Americans.

Cutting your risks

"The risks need to be taken seriously. Fortunately, there are some very positive things you can do to cut your risk at least in half," says Mary Frederick, RN, diabetes program manager for Allina Medical Clinic.

Frederick outlines ways people with diabetes can reduce that risk:

Get a total cholesterol break down every year.

Cholesterol is a fat-like substance made by your liver and found in food. When too much builds up in your artery walls, mounds of fat called plaque form and block blood flow. This can lead to heart disease, stroke and insulin resistance. In turn, insulin resistance causes diabetes.

To make sure they're on the right care plan, people with diabetes should have an annual blood test that examines all three kinds of cholesterol.

LDL (low density lipoprotein) cholesterol is the "bad" cholesterol that can cause plaque to build up in your arteries.
HDL (high density lipoprotein) cholesterol is the "good" cholesterol that helps get rid of extra cholesterol from your blood and tissue.
Triglycerides come from too much fat or too many calories in the food you eat. Your body may use them for energy or store them as fat.

"Don't go to a general screening at a community center, for example. People with diabetes need more detail," says Frederick. "Go to your clinic for a cholesterol test that will report all three kinds. This is a fasting test."

Return to "Cutting your risks"

Regularly check your blood pressure.

At every doctor's visit, have your blood pressure checked. Regular monitoring will let you and your doctor know whether your care plan is working or needs adjusting.

Return to "Cutting your risks"

Manage your medications.

Many people with diabetes are on at least seven medications. They may include two to three for diabetes, two to three to lower high blood pressure, plus a few more for high cholesterol.

Many doctors also prescribe a daily dose of baby aspirin to thin one's blood. This is a good way to reduce the risk of stroke or heart attack.

"Some are tempted not to take all their medications because they’re feeling fine. But this can be dangerous," says Frederick. "It's important to understand that the medications are helping to prevent problems to keep you feeling fine.”

These tips can help you stay on schedule with your medications.

Make a chart or schedule that lists each medicine and when you need to take it. Post it where you can easily see it, for instance, on your refrigerator or near the bathroom mirror.
Use a pill organizer. One helpful kind has a compartment for each day of the week where you can put the pills you need to take.
Maintain a list of medications that you're on. Keep it in your wallet or purse in case of an emergency. Bring it to any doctor appointment. (Our diabetes care card is a handy resource.)

Return to "Cutting your risks"

Get active.

You don't always have to have a formal exercise program. Just try to do at least 30 minutes of physical activity a day.

Simple things like parking further away, doing yard work, using the stairs instead of the elevator and going for walks can help you manage your diabetes and keep your cholesterol and blood pressure at healthy levels.

"Before starting a new activity, always check with your doctor about any restrictions," says Frederick.

Return to "Cutting your risks"

Cut the fat.

The daily diet of many American adults contains too much fat. Reducing daily fat intake to no more than 30 percent can make a good difference.

Here are some fat-cutting tips for...

dairy: Choose low-fat or fat-free buttermilk, low- or reduced-fat cheese (like part-skim mozzarella or cream cheese), skim or 1 percent milk, low- or non-fat sour cream, sherbet, sorbet and low-fat yogurt (soft or frozen). Avoid high-fat cheese (like bleu, cheddar, Colby or Swiss), ice cream, half-and-half and whipped cream, and whole or 2 percent milk.
meat: Choose lean cuts of beef, chicken (no skin), fish (no added oil), lamb, pork, shellfish or turkey. Avoid bacon, bologna, hot dogs, marbled cuts like T-bone steak or roast, organ meats like liver, salami and sausage.
spreads, oils and toppings: Choose avocados, refrigerated peanut butter, tub margarine, low-fat mayonnaise or salad dressings, unsaturated vegetable oils (like canola, corn, olive or safflower), olives and seeds. Avoid butter, peanut butter with hydrogenated oils, chocolate, salad dressing, bacon fat, lard, stick margarine, coconut oil and palm oil.

Return to "Cutting your risks"

Lose weight if your doctor says so.

"You don't have to lose an enormous amount," says Mary Frederick, RN, of Allina Medical Clinic's diabetes program. "Even 10 pounds can make a huge difference in lowering blood pressure, cholesterol and glucose levels."

Weight loss can also improve your body's insulin concentration and sensitivity, important aspects of good diabetes management.

For many, losing weight is a matter of increasing activity and decreasing fat intake. (See Get active and Cut the fat.)

Return to "Cutting your risks"