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January 28, 2009 > Is Your Heart Taking a Beating from Diabetes?

Is Your Heart Taking a Beating from Diabetes?

Heart disease is one of the most life-threatening complications of diabetes. According to the American Diabetes Association (ADA), more than 65 percent of deaths in diabetes patients are attributed to heart and vascular disease. The risk is dramatic - the ADA warns that a diagnosis of diabetes as an adult presents the same risk as already having one heart attack.

"Diabetes is a progressive disease that affects the entire body from head to toe, including all blood vessels, both large and small," says Washington Hospital cardiologist Dr. Ash Jain, Medical Director of the Cardiac Catheter Lab and Peripheral Vascular Services. "Damage to the small blood vessels causes cardiomyopathy, which is a weakening of the heart muscle that can result in heart failure. Damage to the large arteries - including blockages - can cause heart attacks."

The ADA reports that women with diabetes tend to have higher risks of cardiovascular disease and death following a heart attack than diabetic men of the same age. "We are not sure of all the reasons for this difference between men and women, but one reason may be that women have smaller arteries that are more easily damaged," says Dr. Jain.

"Because diabetes causes damage to the body's nerve endings and limits the sensation of pain, people with diabetes who have a heart attack may not have the typical symptom of a crushing pain in the chest," he adds. "Instead, it is more likely that they will have symptoms such as shortness of breath, weakness and extreme fatigue."

To help people in the community learn more about the relationship between diabetes and cardiovascular disease, Washington Hospital is sponsoring a free "Diabetes Matters" class, featuring a lecture by Dr. Jain. A question-and-answer session will follow the lecture. The class is scheduled for Thursday, February 5 from 7 to 8 p.m. in the Conrad E. Anderson, M.D. auditorium in the Washington West Building at 2500 Mowry Avenue in Fremont. Attendees are welcome to attend the diabetes support group that will meet after the lecture from 8 to 9 p.m. (See the box below to learn more information about the diabetes support group.)

"Diabetes is generally slow in progressing, so patients may not sense any symptoms of heart disease for years, so the diagnosis of such problems may be delayed," Dr. Jain notes. "That's why it is essential for people with diabetes to have thorough medical check-ups at regular intervals. An annual exam should include a stress test and an evaluation of the peripheral vascular system."

People with diabetes often have high blood pressure and cholesterol levels, which are additional risk factors for heart disease.

"These factors are all interrelated," Dr. Jain says. "Controlling high blood pressure to the range of 120/80 to 130/90 is very important for people with diabetes. In terms of managing cholesterol, we often recommend that people with diabetes maintain an overall cholesterol level of 150, with the LDL or 'bad' cholesterol level below 100 and the HDL or 'good cholesterol' level above 50. That compares to the general recommendations for people without diabetes of an overall cholesterol level below 200, with the LDL level below 160 and the HDL level above 40. We also recommend that people with diabetes keep their level of triglycerides below 150."

In addition to these guidelines, Dr. Jain offers several other recommendations for reducing your risk factors for heart disease:
* Keep your blood sugar level under control, monitoring it every day to make sure your diet, exercise and any prescribed medications are working.
* Losing weight if you are overweight or obese, since weight loss can help control your blood sugar level, blood pressure and cholesterol levels.
* Increasing your level of physical activity to help your body functioning properly.
* If you smoke, stop smoking, since it damages the blood vessels, which are already at risk of damage from diabetes.

Preventing heart disease is important for everyone - whether you have diabetes or not. But it is especially imperative for people who do have diabetes.

"We do have very excellent interventions available today for treating heart disease, including balloon angioplasty, stents and bypass surgery," Dr. Jain says. "Unfortunately, the results of these interventions are not as good in people with diabetes. We're not sure why that is the case, but it makes prevention of heart disease even more critical for people with diabetes."

"Diabetes Matters" is a monthly program sponsored by Washington Hospital that provides science-based information to help people increase their knowledge about diabetes. The classes, held the first Thursday of every month except July, are free and require no pre-registration. The lectures are videotaped and aired on Washington Hospital's "InHealth" TV Channel. To check broadcast schedules, go to www.whhs.com, click on "For Our Community" and the links for InHealth Channel 78 & Broadcast Schedule. The lectures also are available on DVD in the Community Health Resource Library.


Diabetes Support Group

Success in managing diabetes has a lot to do with receiving and giving social support. For people who suffer from diabetes, Washington Hospital's Outpatient Diabetes Program offers a dynamic support group that allows people to have in-depth conversations about what's happening in their lives and share information about dealing with diabetes in a positive and caring environment. The support group meetings are held at 8 p.m. every month immediately following the hour-long Diabetes Matters lecture which begins at 7 p.m. the first Thursday of each month.

Family members and friends are also welcome. For more information about the support group or other classes and programs, call the Diabetes Services program at (510) 745-6556 or visit us on the web: www.whhs.com/services/diabetes/

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