Diabetics need to look after their hearts

Heart disease and diabetes are unfortunately inextricably linked. So, with around 2,000 to 3,000 people in Cayman suffering from diabetes, a discussion on what diabetes sufferers can do to improve their heart health was a timely update for those attending last month’s Heart Health Fair, organised by Cayman Heart Fund.

Cayman Heart Fund’s Heart Health Fair brought a slew of heart health professionals to the event held at Camana Bay, all imparting their own particular brand of knowledge on the subject matter.

Dr. Diane Hislop-Chestnut, an endocrinology and diabetes expert with Grand Harbour Medical gave a presentation on how diabetes and heart disease are linked. She said although estimates suggest that between four and six per cent of Cayman’s population (2,000 to 3,000 people) suffer from diabetes, the latest census, which recently took place, may well reveal that figure to be much higher, underscoring the importance of education on the issue.

“Diabetes lowers life expectancy by between seven and eight years,” she said. “So women in Cayman with diabetes can expect to live on average until they are 75 as opposed to the average of 83; for men that figure reduces to 70 from 78.”

Hislop-Chestnut said it is extremely important for diabetics to take care of their hearts because they are twice as likely to have cardiovascular disease as compared with non-diabetics and 65 per cent of diabetics die from some kind of CVD, which can include heart attacks, stroke, high blood pressure, congestive heart failure and peripheral vascular disease.

Diabetics have higher risk factors because plaque builds up in their arteries.

“They also are at risk from high blood pressure, high cholesterol and obesity,” she added.

“High blood pressure is particularly common in people with diabetes,” she confirmed. “And the problem is that many diabetics have the disease for a number of years prior to its actual diagnosis, on average six years beforehand. This means that they have most likely also already been suffering from high blood pressure for a while before their diabetes diagnosis.”

Getting down low

Lowering blood pressure means less of a risk of the diabetic developing CVD, says Hislop-Chestnut and she explained that the goal blood pressure reading for diabetics is 130/80 (a normal reading for non-diabetics is 120/80).

Diabetics and non-diabetics can control their blood pressure levels in a number of ways, she said; by maintaining a healthy diet that is low in salt, by being active to reduce blood sugar levels, by losing weight if they are overweight and by taking medication as prescribed by their doctor.

“Sometimes, especially when people feel better after taking a course of medication for blood pressure, patients think they are cured and believe they can stop taking their medication. This is not the case and medications should always be taken as prescribed by a doctor,” she cautioned.

Getting cholesterol levels in balance is also important for diabetics in order for them to stay healthy.

“Bad” cholesterol or ldl levels need to be as low as possible (less than 100 mg/dl) because this type of cholesterol can build up in arteries, and can narrow and harden arteries, raising the risk of developing heart disease. “Good” cholesterol or hdl levels need to be high (60 mg/dl or above) because this cholesterol removes deposits inside arteries, taking those deposits to the liver for removal. Low hdl levels increases the risk of heart disease. The third type of cholesterol found in the body is called triglycerides. These are another type of blood fat that needs to be low as possible (less than 150mg/dl).

Central obesity also plays a part in cholesterol levels within the body, i.e. increased weight, specifically around the mid section.

“Women should not have a waist measurement greater than 35 inches and men 40 inches,” she warned, “otherwise this increases bad cholesterol production in the body.”

“Regular exercise and a diet rich in fibre both play a vital part in lowering bad cholesterol and increasing good,” Hislop-Chestnut said. “If you change your lifestyle for the better you should see an improvement in your cholesterol levels within six to 12 months. It’s not a quick fix.”

According to the doctor, it is vitally important that if a patient is overweight and diabetic they should not be discouraged when it comes to making lifestyle changes.

“A little bit of moderate exercise every day, for example, even as little as 20 minutes will be beneficial,” she confirmed.

Hislop-Chestnut concluded her presentation by explaining the ABCs of good diabetic management – by managing blood glucose levels, blood pressure and cholesterol. Managed correctly they can reduce a diabetic’s risk of developing heart disease and stroke.