How to manage heart health in diabetes

Most diabetics I know, demarcate their lives into two parts: one is before the day they got diagnosed with diabetes and the second [more arduous] part is with the knowing that they have to now live with this incurable disease. Yes, diabetes is tricky and complex, because any slip in maintaining healthy blood sugar control can affect any part of your system, especially the heart health. But, it doesn’t have to be all doom and gloom though—there are plenty of ways to keep your heart healthy even while having diabetes, just as the millions of diabetics out there who do, while living normal and active lives.

If you’re a diabetic, here are 10 keys that will help you keep your heart in top shape:

1. Eat healthy – A healthy diet can help reduce the risk of developing heart diseases and can also increase the chances of survival after a heart attack. Try to have a balanced diet containing plenty of fresh fruit and vegetables, fish and starchy foods such as whole-grain bread, pasta and rice. Have whole-wheat flour and avoid maida [finely refined flour]. And yes, you don’t have to avoid white rice—simply replace it with brown rice. Stay away from snack foods like biscuits, cakes, pastries, samosas, kachoris, chips and namkeen mixtures. Also keep away from dairy products that are high in saturated fats, sugar, and oils and eat as little as you can of foods that contain trans fats.
2. Be active – Aim for half an hour of exercise at least four days a week. Think of ways to increase your activity throughout the day, such as taking the stairs instead of the elevator, playing with your kids and walking to the local grocery store instead of driving down. If you are diabetic and haven’t been active recently, visit a doctor for a check-up before starting any exercise programme and ask what activities are best for you. If you feel uncomfortable at any point while exercising, stop and rest immediately. Later, go see your doctor.
3. Give up smoking – Smoking is harmful to everyone but it’s even worse for diabetics because of the damage it causes to the blood vessels. So much so that if a person has diabetes and is also a smoker, the risk of getting a heart disease doubles. Quitting smoking is the single-most important thing you will do for yourself once you’ve been diagnosed with diabetes.
4. Have a heart test – There are both typical and atypical symptoms of heart diseases and it is important to be aware of them and to visit your doctor immediately if you feel any of them. For example, the early symptoms of heart disease are a tightness in the chest, neck, arm or stomach, which comes when you exert yourself but goes away later. If left untreated, it could lead to a heart attack. Unfortunately, diabetics sometimes do not feel chest pain because of the nerve damage caused by poorly-controlled diabetes. The symptoms felt, if any, are ignored or are passed off as indigestion, stomach upset or dizziness. To avoid this, routine heart screening, ECG and stress tests are essential to assess the heart’s condition and reduce the risk of heart attack.
5. Monitor glucose levels – Apart from pro-active steps such as changing your diet and exercising, there are other things you can do that seem mundane but are an essential part of your bodily ‘housekeeping’. For example, check your blood glucose at least once every three days [and if your condition is worse, once a day] and note it down in your record book.
6. Know when to change your treatment – Type-2 diabetes is a progressive disorder and you may require a periodic change in the treatment plan. One thing you could do to know when to change your medication is to take an HbA1c test, which gives you your average blood glucose of the past two to three months. If you’re diabetic, as long as it is under 7 per cent you’re fine but once it goes above 7.5 per cent, you might need to change how you’re being medically treated.
7. See if you need insulin earlier – Early use of insulin can bring flexibility and control to the life of a person with diabetes. In many research studies, early insulin treatment and intense diabetic control in the early period has been found to postpone long-term complications. With thin needles and pen devices like the flex pen, insulin therapy is easier and a lot more comfortable than it used to be.
8. Get your blood pressure under control – High blood pressure can make your heart, eye, or kidney diseases worse, so have it checked every time you see your doctor. The target for most people with diabetes is to get it under 130/80.
9. Check your cholesterol – Have it done at least once a year. People with diabetes should keep their LDL, or bad cholesterol, below 100 and their HDL or good cholesterol above 40. Triglycerides, another type of fat in the blood, should also be kept below 150.
10. Treat other risk factors – Type-2 diabetes often coexists with other conditions such as hypertension, high cholesterol and obesity and it is necessary to address these cardiovascular risk factors. Ask your doctor what medication you should take to minimise the risk they pose, while controlling diabetes at the same time. A new class of treatment called GLP-1 based therapy is particularly promising as it offers better cardiovascular benefits for people with type-2 diabetes.

Living with diabetes is a difficult situation and the added risk of heart disease only makes matters worse. However, it needn’t be more stressful than it already is. With a proper diet, daily exercise and regular check-ups, you can head off the various complications of the disease. And eventually one day, it will be you, and not diabetes, that runs your life.

This was first published in the July 2013 issue of  Complete Wellbeing.