Diabetes and connection with heart disease

People with diabetes have an elevated risk of heart disease.
A person with diabetes has a higher risk of developing heart disease, and that too 10 to 15 years earlier than individuals without diabetes.

The risk of heart disease is further increased if you have…
• Family history of heart disease
• Extra weight around the waist
• Abnormal cholesterol levels
• High blood pressure
• Habit of smoking / alcohol consumption
• High levels of stress

Diabetic Heart Disease
Diabetic heart disease includes coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy.

Coronary Heart Disease
In coronary heart disease (CHD), a waxy substance called plaque builds up inside the coronary arteries. These arteries supply heart muscle with oxygen-rich blood. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. The buildup of plaque may partially or completely block blood flow.
Diabetic atherosclerosis can lead to chest pain or discomfort called angina, irregular heart beat called arrhythmia, a heart attack, or even death.
Heart Failure
Heart failure is a condition in which your heart can’t pump enough blood to meet the body’s needs. The term “heart failure” doesn’t mean that the heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.
If you have heart failure, you may tire easily and have to limit your activities. Diabetes can lead to heart failure by weakening the heart muscle over time.
Diabetic Cardiomyopathy
Chronic diabetes can also lead to diabetic cardiomyopathy where the heart muscle weakens, the heart enlarges and the pumping action of the heart gradually fails.
Heart disease can be prevented in a person with diabetes
The best way to prevent heart disease is to take good control of diabetes.
• Keep blood sugar as normal as possible
• Control blood pressure, with medication if necessary. The target for people with diabetes is under 130/80 mmHg
• Keep cholesterol numbers under control. Low density lipoprotein (LDL or bad cholesterol) should be below 100 mg/dL, High density lipoprotein (HDL or good cholesterol) should be higher than 40 mg/dL in men and higher than 50 mg/dL in women. Triglycerides should be lower than 150 mg/dL
• Lose weight if obese
• Exercise regularly. The American Diabetes Association recommends at least 30 minutes of aerobic exercise five days a week
• Eat a heart-healthy diet. Reduce consumption of high-fat and cholesterol-rich foods such as fried foods, red meat and egg yolk, and eat more high-fiber foods, including whole grains, vegetables, and fruits
• Quit smoking / abstain from alcohol
• Manage your stress better

Diabetes friendly diet

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Making healthy food choices and tracking eating habits help to manage blood glucose level better. If you are diabetic, you should choose foods rich in complex carbohydrates, fiber, proteins, vitamins and minerals, and stay away from unhealthy fats and sweets as much as possible.
• Healthy carbohydrates. During digestion, sugars (simple carbohydrates) and starches (complex carbohydrates) break down into glucose. The latter group is preferred to the former as it does not cause a rapid rise or frequent fluctuations in your blood glucose level. So, focus on the healthy carbohydrates such as whole wheat, oatmeal, brown rice, barley and millets.
• Fiber-rich foods. Dietary fiber includes all parts of plant foods that your body can’t digest or absorb. Fiber can decrease the risk of heart disease and help control blood sugar levels. Foods high in fiber include vegetables, especially green leafy vegetables, fruits and whole grains.
• Good fats. Foods containing monounsaturated and polyunsaturated fats such as nuts (almonds, pistachios and walnuts), vegetable oils (sunflower, rice bran, olive and sesame oils) and fish (if you’re in the habit of eating fish) should be a part of your daily diet. Lean meat (skinless chicken and poultry) has lesser unhealthy fats than red meat (mutton, beef, poultry) and can be had occasionally.

Sample diet chart for Diabetes

Upon waking up: 1 to 2 glasses of water

Breakfast: Idli (3) / Dosai (2), 1 cup boiled/raw vegetables, Sambar/ vegetable/green leaf chutney

Mid morning: Butter milk / Lime juice (without sugar) – 250ml or Fruits 100gms

Lunch: Boiled rice/Brown rice(1-1½ cups) with dhal sambar, buttermilk and more vegetables and leafy greens

Afternoon: Half cup sundal/sprouts

Pre-dinner (or pre-bedtime): Cut fruits (100gms)

Dinner: One cup of vegetable salad, 2 Chapathis/Rotis with dhal, vegetable gravy

Advised to have 2-3 hours gap between dinner and bedtime.