SPR I NG 2019 / DI A BETIC LI V ING 35
Balance
The Keys to Your Heart
Overwhelmed by managing diabetes and caring for
your heart? Focus on these 4 areas for maximum benefi t.
BY HALLIE LEVINE
W
hen you have diabetes,
you may be focused
on managing your
blood sugar. But it’s
important to think about keeping your
heart healthy too. Over time, high blood
glucose levels can damage your blood
vessels and the nerves that control
them, so people living with diabetes
have an increased risk of heart disease
and stroke, explains Clyde Yancy, M.D.,
chief of cardiology at Northwestern and
a spokesperson for the American Heart
Association. But even when you have di-
abetes, heart disease isn’t inevitable, and
there’s a lot you can do to lower your
odds, says Yancy. Focus on these four
areas for a healthier heart.
Learn Your Heart-
Healthy Numbers
You probably already know your A1C
and what your goal range should be. But
you should keep an eye on your blood
pressure and cholesterol numbers too.
Th e American Diabetes Association
(ADA) recommends that most people
with diabetes aim for a blood pressure
of under 140/90 mmHg, but you and
your doctor might decide that a lower
target of 130/80 or 120/80 mmHg is
right for you. Tamanna Singh, M.D.,
a cardiologist at the Cleveland Clinic,
recommends that PWDs with a higher
risk of coronary artery disease aim for
a blood pressure under 130/80 mmHg.
Th e American Heart Association
recommends keeping triglycerides
under 150 mg/dL and aiming to keep
HDL cholesterol (the good kind) at
40 mg/dL or above for men and 50
mg/dL or above for women. Th e ADA
recommends gett ing your cholesterol
levels checked at least every fi ve years if
you’re under 40, and annually for those
over 40 and for people taking a statin.
Make Some Smart
Tweaks to Your Diet
Focusing on increasing heart-healthy
fats and lowering saturated fat and
sodium can help reduce your risk of
heart disease and stroke. A great way to
do this is to focus on eating more plant-
based foods like fruits, veggies, whole
grains, legumes, nuts, and heart-healthy
oils like olive and canola oil, and eating
fewer highly processed foods. Th is
style of eating not only protects you
against heart disease, it also can help you
manage your diabetes, particularly when
you stick within a calorie range that
doesn’t lead to weight gain, says Jeff rey
Mechanick, M.D., a diabetes specialist
and medical director of the Marie-
Josée and Henry R. Kravis Center for
Cardiovascular Health at Mount Sinai
Heart in New York City.
You don’t have to be a gourmet chef
to tweak your eating style. Simple, small
changes such as eating tuna or salmon
twice a week, snacking on a small handful
of nuts every day, and keeping an eye
on your salt intake can go a long way.
Another smart tweak is to add more
produce to your meals the ADA
recommends aiming for 8 to 10 servings
per day for heart health. Consider adding
some shredded carrots or zucchini to
your pasta sauce, or replacing some of
the ground meat in burgers or meatloaf
with cooked chopped mushrooms. Want
more guidance? Try following either the
Mediterranean Diet or the DASH diet,
both of which have been shown to lower
the risk of heart disease.
Get Moving
Staying active improves insulin
sensitivity, lowers blood sugar, and
boosts overall heart health by keeping
your blood vessels fl exible and strong.
Th is means not only aiming for regular
exercise, but also trying to move more
throughout your day. A good goal for
most people is 150 minutes per week
of moderate exercise that raises your
heart rate, like brisk walking (roughly
30 minutes a day, 5 times a week), plus
aiming to get up and move for at least
3 minutes every 30 minutes, to avoid
prolonged sitt ing. If you can’t squeeze
in a full half-hour of exercise at once, it’s
fi ne to divide it into 10- or 15-minute
chunks of activity.
Take the Right Meds
Th e more oft en your blood sugar is in
a healthy range, the lower your risk of
developing heart disease, stresses Evan
Sisson, Pharm.D., a certifi ed diabetes
educator and professor at VCU School
of Pharmacy in Richmond, Virginia.
Consistently taking your diabetes
medications will help reduce your
overall heart disease risk, because it
helps you manage your blood glucose
levels. But you may also require other
heart drugs. If your blood pressure
is 140/90 mmHg or above, the ADA
recommends starting blood pressure
medication, and if it’s 160/100 mmHg
or higher, they recommend taking two
blood-pressure-lowering meds. If you’re
40 or older, the ADA recommends
taking a cholesterol-lowering
medication such as a statin, especially
if you have risk factors for heart disease
such as high blood pressure, elevated
cholesterol, chronic kidney disease,
or tobacco use. PWDs of any age who
have a history of cardiovascular disease
should be taking a statin, says Singh.
It’s a good idea to regularly review your
medication regime with your doctor,
because there may be new medications
available that are more eff ective or
less expensive than the ones you’re
currently on.
