February is Heart Month in Canada with the aim of bringing our attention to heart/cardiovascular diseases. It is a time for all of us to become aware of its mortality and impact on Canadian lives. Diseases of the heart accounted for 18.5% of the deaths in Canada in 2019 meaning about 52,000 people. (1)
Heart disease is a group of conditions that affect the structure and function of the heart. There are many causes of why this may happen and it seems that having diabetes is one of the many causes. I will explain more as we progress through today’s discussion.
To understand why our hearts malfunction we must first understand how the heart works. Think of your heart as a muscle, about the size of your fist and its main job is to pump blood around your body. Each time the heart beats, blood is delivered to your body parts through the arteries and veins. One of the main purposes of blood being carried throughout our body is because the blood delivers oxygen and nutrients to all our cells. It also takes away waste products and carbon dioxide. The arteries are responsible for carrying this oxygen-rich blood from our heart throughout our body and the veins carry the oxygen-poor blood back to our heart and lungs so the cycle can start over again. (2) To learn more I invite you to visit this website.
There are many types of heart disease. You many hear the term “cardiovascular disease” which is similar and includes all types of heart disease including stroke and blood vessel disease.
Heart disease may be due to: (not all inclusive)
· blocked arteries in your heart
· the heart beat may be too slow or too fast
· the valves in the heart may be abnormal and
· heart failure which develops after the heart has become damaged or weakened
Contributing factors for heart disease:
1) High or uncontrolled blood pressure, high cholesterol levels and diabetes all increase our risk of heart disease. High blood pressure increases the force of blood through your arteries and can damage artery walls. Having high blood pressure and diabetes can greatly increase your risk for heart disease. The blood pressure goal is less than 130/80 when you have diabetes.
2) Lifestyle factors that contribute to the risk include obesity, lack of physical activity, stress, and an unhealthy diet just to mention a few.
3) Risk factors that we cannot control include sex, age, family history, genetics and race.
Why does diabetes cause us to have an increase risk of heart disease?
The link between diabetes and heart disease begins with high blood sugar levels. Over time, the high glucose that is in your blood can damage the arteries, blood vessels and the nerves that control your heart. Because the arteries have become stiff and hard, fatty deposits (plaque) builds up on the inside of these blood vessels. If this happens then blood flow to the heart or brain may be blocked causing a heart attack or stroke.
Warning signs of a heart attack include: (not all inclusive)
· chest discomfort- pressure/squeezing feeling, burning or heaviness
· chest pain along with shortness of breath
· sweating for no known cause (be careful as it could be hypoglycemia- be sure to check your blood glucose )
· light-headedness, nausea
Seek medical attention immediately.
NOTE: symptoms may differ for men and women and each individual.
As we know high blood glucose and high levels of fats in the blood from diabetes can damage nerves and the small blood vessels that nourish these nerves leading to a condition known as autonomic neuropathy. This autonomic neuropathy can damage the nerve fibres that supply our heart and blood vessels resulting in abnormalities in the heart rate control and function of the vessels. I mention this because this type of nerve damage may hide the warning signs of a heart attack. Instead of feeling chest pain during a heart attack you many only have sudden fatigue and sweating. (accessed on line Feb 19th,2021). I know my own physician has mentioned this to me from time to time through the years to keep me on my toes perhaps.
Suggestions for decreasing our risk of heart disease include the following:
1) If you smoke, please quit. Smoking increases the formation of plaque in the blood vessels. It causes the blood to thicken and form clots inside our veins and arteries. Ask for guidance to get you through this rough time of smoking cessation.
2) If you are overweight, try to shed a few kilograms. Shedding a few kilograms can help reduce blood pressure and blood sugar levels. Every kilogram lost counts towards a healthier self.
3) Keep blood glucose within the target range. Have your A1C checked every three months or at least twice a year.
4) Eat nutritious meals. A healthy meal plan doesn’t mean you have to go hungry. Consult a dietitian at your diabetes clinic or an outside source if the wait is too long. Before COVID-19 many grocery store dietitians were giving tours and discussing healthy meal plans with individuals and groups. Check out Canada’s food guide to get you started. Take time and write down what you eat now and looks at ways you could trim down the amount of calories.
5) Engage in physical activity. Physical activity is defined as any bodily movement produced by muscle that requires energy and uses calories. The Diabetes Canada guideline recommends 150 minutes a week of aerobic exercise like walking, biking, jogging. You should also try to do weight/resistance training two times per week. Always check with your health care providers to be sure other health conditions don’t interfere with starting an activity. Check this website to find out what even just 10 minutes of physical activity can do for you.
6) Don’t stop any medications unless advised by your health provider team. Adhere to your medication regime for your diabetes and other chronic conditions. Remember, if your diabetes and/or blood pressure is in good control this is due to the effectiveness of the medication and it doesn’t mean you can stop at any time. Check out my earlier blog to learn more about being consistent in taking your medication.
7) Manage stress since it can raise your blood pressure and blood glucose values. Often your health care team has experts they can refer you to for counselling about stressful events and how better to cope. Diabetes alone is stressful but often just talking and sharing feelings to someone else is helpful.
There are several medications that a person can use to manage blood pressure, blood glucose, anxiety, stress and heart disease. Medications are only one part of management, they are not a cure all for everything. Many of the newer diabetes medications have some heart benefits so this is good news. It is still up to us to do what we can to improve our overall health.
I hope today's topic has increased your awareness of the presence of heart disease in those of us with diabetes. It is never too late to make changes to improve our health.
The information provided is not intended to replace that of your health-care providers. It is meant for information purposes only.
References:
1) Statistics Canada- accessed on line February 14th, 2021
2) Heart and Stroke Foundation accessed on line February 14th,2021
4) Diabetes Canada Guidelines -accessed on line February, 2021
It has been one year since I started my blog and I have learned from doing my research and I hope you have as well. Don't be shy to share your comments or ideas for topics. Forward this blog to someone who might find the topics of value. Thank you for your time. Stay healthy.
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