Friday, May 28, 2010

Heart and Diabetes

Heart and Diabetes

A person with diabetes is more likely to develop heart problems condition than others and tends to develop it at an earlier age than others. Studies suggest that the chances of middle-aged people with Type 2 diabetes getting a heart attack is as high as someone who has already had an heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes are at an increased risk of heart disease.

Why are people with diabetes at risk of heart disease?

Uncontrolled diabetes can cause damage to many parts of the body, including blood vessels resulting in coronary artery disease. This damage makes it easier for fatty deposits to form in arteries and cause narrowing or blockages that can lead to heart attacks or strokes. Along with diabetes, high blood pressure, high blood cholesterol, smoking, lack of exercise and obesity also lead to atherosclerosis (narrowing of arteries).

Those with diabetes are likely to suffer from what is called "silent ischemia" or silent heart attack, which accounts for 25-30 percent of heart attacks. It is Termed "silent" as the patient gets a heart attack with no chest pain. People with diabetes usually don't feel chest pain because of nerve damage caused by poorly controlled diabetes.. The symptoms of silent ischemia are generally ignored or passed off as indigestion or stomach upset, vague dizziness or weakness.

What can one do to prevent or delay heart disease and stroke?

Even if a person with diabetes is at high risk for heart disease and stroke, he/she can help keep his/her heart and blood vessels healthy. A person with with diabetes can do so by taking the following steps to prevent heart diseases.

1. Keep blood sugar level under control. Balanced diet, regular exercise, right medicine and monitoring are essential to keep blood sugar levels under control.

2. Make sure that your diet is balanced. A dietician can help you get it right. Food with high fiber may help lower blood cholesterol. Whole-grain breads and cereals, dried beans and peas, fruits and vegetables are rich sources of fiber. Also cut down on saturated fat because it raises blood cholesterol level. Saturated fat is found in meats, poultry skin, butter, dairy products with fat, such as palm and coconut oil. Keep the cholesterol in your diet to less than 300 milligrams a day. Cholesterol is found in meat, dairy products and eggs. You need to keep the amount of transfat, a type of fat in food that raises blood cholesterol in diet to a minimum. Limit your intake of samosas, vadas, namkeens and chats.

3. Make physical activities part of your routine. Being physically active can be good for everyone's health. Like eating a healthy diet, exercise will also help keep blood sugar level normal and can lower risk of heart disease. Aim for at least 30 minutes of exercise most days of the week. Think of ways to increase physical activity, such as taking the stairs instead of the elevator, playing with your child and walking into nearby grocery shop instead of taking a vehicle. If a person with diabetes hasn't been physically active recently, it is necessary to visit a doctor for a check-up before starting an exercise program.

4. Reach and maintain a healthy body weight. Consult a dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight. Aim for a loss of not more than 0.5 to 0.9 kilograms a week.

5. Quit Smoking. Smoking is bad for everyone but it's even worse for people with diabetes because it damages the blood vessels. If a person has diabetes and is also a smoker, the risk of getting heart disease is doubled.

6. Ask your doctor whether you should take aspirin. Studies have shown that taking a low dose of aspirin every day can help reduce the risk of heart disease and stroke. However, aspirin is not safe for everyone. Your doctor can tell you whether taking aspirin is right for you and exactly how much to take.

You can keep track of the ABCs of diabetes to make sure your treatment is working. A stands for HbA1C (A1C is a test that measures blood glucose control over last 3 months), B for blood pressure and C for cholesterol. Talk with your health care provider about the best targets for you.

Have an HbA1C test at least twice a Year. It shows your' average blood" glucose level over the past 3 months. Insulin is recommended if HbA1C is more than 9.5% at the time of diagnosis or more than 7.5% even after taking Oral Drugs.

Control of the ABCs of diabetes can reduce your risk for heart disease and stroke. If your blood glucose, blood pressure, and cholesterol levels aren't on target, ask your doctor what changes in diet, activity, and medications can help you reach these goals. By taking these simple steps, every person including people with diabetes can enjoy a healthy and long life.

Q. Can diabetes be cured ?
Diabetes cannot be cured, but can definitely be controlled. People with diabetes can lead a healthy life if their diabetes is well controlled (i.e. when their blood sugar levels are 90-130 mg/dl at fasting and less than 180 mg/dl 2hrs after meals) and other parameters like lipid profile, blood pressure and weight are in prescribed limits.

Q. Can I include fruits in my meal?
All people with diabetes should have at least 2 servings of fruit per day. One serving of fruit should contain 15 grams of carbohydrates. The size of the serving depends on the carbohydrate content of the fruit. The advantage of eating a low-carbohydrate fruit is that you can consume a larger portion. But whether you eat a low-carb or high-carb fruit, as long as the serving size contains 15 grams of carbohydrates, the effect on your blood sugar is the same.

The following fruit servings contain about 15 grams of carbohydrates: 1 Small Apple = 1/2 medium banana =1 1/2 slice mango = 1 1/4 cup watermelon = 1 Guava =15 Grapes = 1 Oranqee = l Peach = 1/2 pomegranate =1 kiwi = 3 Dates = 1/2 chikoo = 2-3 slice of papaya = 3 Plums = 1 1/2 slice pineapple.

So, a person with diabetes can eat any fruit, but the quantity should be measured.

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