HEART HEALTH
People with Type 2 diabetes need to look after their cardiovascular system,
It’s well known that the pancreas plays a starring role in diabetes because it produces the insulin that controls blood sugar. But I’m also interested in how well another major player is being supported — your cardiovascular system, which includes your heart and blood vessels.
People with this chronic illness are at a two to four times greater risk of developing cardiovascular disease (CVD). Furthermore, between 60 and 80 per cent of people with Type 2 diabetes (T2D) will die of CVD.
Lifestyle factors can have a big effect on both T2D and heart health.
Increasing your activity, eating well to maintain a healthy body weight and quitting smoking are well known to be helpful for these conditions — and many others.
Maintaining healthy cholesterol and blood pressure levels can go a long way to protecting your heart from cardiovascular issues. These can include heart attack, stroke or vascular conditions like hardening of the arteries called atherosclerosis.
Keeping your blood sugar in good control reduces CVD as well as other important complications of diabetes.
Some patients tell me they’d like to avoid taking medications. But today, there are many diabetes therapies that didn’t exist 10 or even just five years ago that can be a big help for controlling diabetes and reducing the risk of its devastating complications.
Many of these drugs are even included in the Ontario Drug Benefit Plan.
About 3.4 million Canadians live with diabetes — or, more than 9 per cent of our country’s population. By 2025, Diabetes Canada estimates that as many as five million Canadians will have diabetes.
The majority of people who have diabetes have T2D. In this condition, the body isn’t able to properly use the insulin it makes — this is known as insulin resistance.
As well, the pancreas doesn’t make enough of the hormone to overcome the insulin resistance.
Last month, I helped lead a symposium for health professionals here in Toronto aimed at transforming the landscape of cardiovascular and diabetes care.
The event is just one example of the exciting things happening here to help people living with these conditions.
At my academic home — the University of Toronto’s Faculty of Medicine — researchers are looking at various intersections and risks of T2D and CVD. To give a few examples, scientists at the University of Toronto’s Banting and Best Diabetes Centre are exploring the mechanisms of disease and clinical scientists are running randomized trials with medications in diabetes to try to find the best combinations of drugs to take.
Here are a few tips to help you manage your diabetes and keep your heart healthy: Make some dietary changes: It doesn’t take a specific or extreme diet to benefit from changes to your eating habits — small improvements can go a long way. Small weight losses can lead to improvements: Losing 5 to 10 per cent of your body weight can have an effect on your blood sugar and reduce the need for medical therapies. Don’t be afraid to ask for help: If you’d like some extra support, make an appointment at your local diabetes education program. These centres are staffed by diabetes nurse educators and dieticians who can offer information and resources to help you make positive changes.
Increase your activity: Diabetes Canada recommends 150 minutes of moderate intensity exercise per week plus some resistance training. You don’t have to exercise for long to get the benefit — breaking your activity up into three 10-minute long bursts may be as helpful as doing a single half-hour session. We may not all be able to do a 10-kilometre run, but there are ways for everyone to incorporate more activity into our lives. Ask your doctor what kind of activity might be safe and suitable for you.
Don’t discount medication: If lifestyle factors aren’t sufficient to control your blood sugar, cholesterol or blood pressure, you may benefit from taking medications, which have been proven to be both safe and very effective. Talk to your doctor about whether there are medications that might help you reduce these risks. Research has shown that some people who can get these factors close to their targets can greatly lower their risk of cardiovascular disease. Dr. Phillip Segal is an assistant professor in the department of medicine, division of endocrinology at the University of Toronto’s Faculty of Medicine. He is also medical director of the Endocrinology Clinic at University Health Network and directs the Quality, Education and Safety Committee (QUEST) of the Banting and Best Diabetes Centre of the University of Toronto. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine.