The trouble with cohabitation:

Diabetes and heart disease in the same house

Last week we talked about what heart disease IS and basics on why it occurs in people with diabetes. This week we will talk about how they affect each other once they have decided to live in the same body. As my mother would say, cohabitation is a bad idea…{{more}}

The effect of diabetes on heart disease: Having diabetes, particularly POORLY controlled diabetes, firstly causes heart disease to develop earlier than you might otherwise expect. People who develop heart disease in their 60s may instead develop notable heart disease in their 50’s, or even 40’s, if their blood sugars run high for too long.

The second major effect of diabetes on heart disease was discussed briefly in a prior article: diabetes can turn heart disease into the Great Pretender. Yes, indeed, you may never have any chest pain or look like Fred Sanford grabbing his chest and staggering across a floor saying: “Elizabeth, I’m coming to you Elizabeth!” Instead you may complain of some heartburn or indigestion for a little bit, maybe even on and off for a few days. You may have some nausea, maybe some belly pain. Your neck might hurt. Your arm may tingle or go numb for a few minutes. You may just feel really run down for a day or suddenly out of shape when you try to climb the stairs to your house. When you have diabetes, heart disease takes all shapes and forms when it visits, so ANYTHING out of the ordinary is cause for attention.

Vice Versa: Heart disease and how it affects your diabetes

Never thought of this one, did you? Well, in fact, there are a few important points about this relationship.

First, when we KNOW you have heart disease, the bar for many things is different than if we are not sure you do. For instance, if we do not know you have heart disease, your goal for bad cholesterol (LDL) levels is less than 100, and, of course, if we get it lower we are happy. But if you have known heart disease, the goal is 70 or lower.

This second one, of course, should not surprise you, but if we know you already have diabetes, then the goal of getting your blood sugars controlled is even more important. If you have had a heart intervention like some stents, a “cleaning out” of the heart vessels, or a complete surgical heart bypass, we watch your blood sugars and cholesterol like hawks because we don’t want those interventions to be reversed by bad diabetes control. Now we don’t want it controlled TOO tight-no one wants you having a bunch of low blood sugars all day because that is dangerous, especially in people with heart disease. But we do want it under good control: Hemoglobin A1C target is 7%. Remember that number: 7%.

Think on these things! Until next week, stay safe and healthy, Vincies…

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227