Diabetes and Heart Groups Fight against Heart Disease
Two groups, the American Diabetes Association (ADA) and the American Heart Association (AHA), are working together to show evidence supporting lifestyle and medical interventions that can help to prevent the development of heart disease in persons with diabetes.
The statement was published in Circulation: Journal of the American Heart Association and the American Diabetes Association journal, Diabetes Care.
Joint guidelines from the two organizations encourage more aggressive prevention and treatment of the risk factors that lead to heart disease, the number one cause of death for persons with diabetes.
Persons with diabetes are two to four times as likely as those in the general population to suffer cardiac events or stroke.
They are also far less likely to survive a cardiac event should one occur, than someone who does not have diabetes. But their risk can be reduced, and these guidelines provide the needed information.
Traditional lifestyle changes for people with diabetes have focused on weight loss.
These new joint guidelines emphasize a need for major interventions that more significantly reduce CVD risk factors.
It continues to cite the importance of achieving a healthy lifestyle, based on increased physical activity, medical nutrition therapy, and weight control.
In addition, the statement calls for increased medical interventions, such as the use of statins, ACE inhibitors, and other medications to manage lipids, blood pressure, and blood glucose levels in persons with diabetes.
The recommendations apply equally to persons with type 1 and type 2 diabetes.
These joint guidelines are part of an ongoing effort by the two organizations to coordinate efforts in the fight against cardiovascular disease, which affects two out of three persons with diabetes.
"Diabetes is a deadly disease, but the truth is that most people who have it will actually die from heart disease, its most common and too often fatal complication," says Dr. John Buse, president-elect for medicine and science at the ADA.
"Thanks to decades of research, we now know quite a bit about how to lower the risk for heart disease - whether you have diabetes or not,” says Dr. Buse. “But these risk factors often aren't treated aggressively enough, and the people who are living with diabetes aren't benefiting from this knowledge.
“We hope this joint statement will encourage physicians to put this knowledge to use in a more consistent manner," he says.
Dr. Henry Ginsberg, at the College of Physicians and Surgeons of Columbia University in New York City, says, "We must practice primary prevention of cardiovascular disease in patients with diabetes.
"Once a person with diabetes has a heart attack or stroke, they do much worse than people without diabetes,” says Dr. Ginsberg.
“If you have diabetes and have a heart attack, you don't do as well after a stent or after bypass surgery, and your chance of dying in the next 12 months is much higher," explains Dr. Ginsberg. “Both associations have been very active in educating healthcare professionals about the links between diabetes and cardiovascular disease.
“It was natural for us to join forces and provide a comprehensive review of the evidence, and guidelines based on that evidence, for the primary prevention of cardiovascular disease in our patients with diabetes," he concludes.
Always consult your physician for more information.
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Diabetes is a metabolic disorder characterized by a failure to secrete enough insulin, or, in some cases, the cells do not respond appropriately to the insulin that is produced.
Because insulin is needed by the body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood.
Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, malnutrition, infections, viruses, or other illnesses.
The three main types of diabetes - type 1, type 2, and gestational - are all defined as metabolic disorders that affect the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body.
In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes.
However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases.
Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.
For glucose to be able to move into the cells of the body, the hormone insulin must be present.
Insulin is produced primarily in the pancreas, and, normally, is readily available to move glucose into the cells.
However, in persons with diabetes, either the pancreas produces too little or no insulin, or the cells do not respond to the insulin that is produced.
This causes a build-up of glucose in the blood, which passes into the urine where it is eventually eliminated, leaving the body without its main source of fuel.
Although the three main types of diabetes are similar in the build-up of blood glucose due to problems with insulin, there are differences in cause and treatment:
type 1 diabetes
Type 1 diabetes is an autoimmune disease in which the body's immune system destroys the cells in the pancreas that produce insulin, resulting in no or a low amount of insulin. People with type 1 diabetes must take insulin daily in order to live.
type 2 diabetes
Type 2 diabetes is a result of the body's inability to make enough, or to properly use, insulin. Type 2 diabetes may be controlled with diet, exercise, and weight loss, or may require oral medications and/or insulin injections.
gestational diabetes
Gestational diabetes occurs in pregnant women who have not had diagnosed diabetes in the past. It results in the inability to use the insulin that is present and usually disappears after delivery.
Gestational diabetes may be controlled with diet, exercise, and attention to weight gain. Women with gestational diabetes may be at higher risk for type 2 diabetes later in life.
Always consult your physician for more information.
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