Transcript Document

Diabetes and Heart
Disease
Bridgette Williams, FNP-BC
Cardiology Nurse Practitioner
Cape Fear Heart Associates
February 2015
Objectives
1. Know what diabetic heart disease is and the impact on the
population.
2. Understand the role of diabetes in heart disease.
3. Know what your recommend cholesterol levels should be.
4. Understand changes you can make that will impact your
overall health and well being.
5. What questions do you need to ask your medical provider.
Cardiovascular disease is the leading cause of death among many people
with diabetes, yet much of the population remains unaware of the risk.
75% of people with diabetes will have heart disease
Types of Heart disease include:
• Coronary artery disease. Your coronary arteries are in your heart. Fatty
deposits, called plaques, can narrow them. If plaque suddenly breaks, it
can cause a heart attack. Exercise, eating a healthy diet, and not smoking
are musts.
• Congestive heart failure. This is an ongoing condition in which the
heart loses the ability to pump blood effectively. The main symptoms are
shortness of breath when you're moving and leg swelling.
• Many people have both conditions
People with type 1 diabetes who have also developed some degree of
insulin resistance may be at an increased risk for heart problems, as insulin
resistance has been associated with cardiovascular problems.¹
1. National Institute of Diabetes & Digestive and Kidney Diseases (NIDDK]
What is diabetic heart disease?
The term "diabetic heart disease" (DHD) refers to heart
disease that develops in people who have diabetes.
Compared with people who don't have diabetes, people who
have diabetes:
• Are at higher risk for heart disease
• Have additional causes of heart disease
• May develop heart disease at a younger age
• May have more severe heart disease²
2. http://www.nhlbi.nih.gov/health/health-topics/topics/dhd
How does Diabetes impact heart disease?³
1.
Diabetes alone is a very serious risk factor for heart disease. People
who have type 2 diabetes have the same risk of heart attack and dying
from heart disease as people who already have had heart attacks.
Other risk factors include :
Smoking, High blood pressure and high cholesterol
2.
If you combine other risk factors, diabetes further raises the risk of
heart disease. It's clear that diabetes and other conditions—such as
being overweight, cause harmful physical changes to the heart.
3.
Diabetes raises the risk of earlier development of more severe heart
problems. People who have DHD tend to have less success with some
heart disease treatments, such as Open heart surgery / Bypass surgery
and the placement of stents.
4.
Remember - Patients with diabetes can have “atypical” symptoms
when having a heart attack. Listen to your body.
3. http://www.nhlbi.nih.gov/health/health-topics/topics/dhd
The possible warning signs of a heart attack include:
• pressure, squeezing, fullness, and pain in the chest or upper body.
You may also have shortness of breath
• The signs of a heart attack for a woman may be different than a man.
Signs for a woman can include nausea and vomiting, being tired all
the time (sometimes for days), and pain in the back, shoulders, and
jaw.
• Call 9-1-1 right away if you think you are having a heart attack
Acting fast can save your life
The National Diabetes
Education Program
(NDEP) recommends that
diabetes patients maintain
cholesterol levels of:
LDL (bad cholesterol)
< 100mg/dl (and < 70
mg/dl for those considered
“very high risk”*)
HDL (good cholesterol)
> 40 mg/dl in men and >
50 mg/dl in women
Triglycerides < 150
What are my numbers?
Eat your way to a healthy heart
Nutrient-rich foods have vitamins,
minerals, fiber and other nutrients but
are lower in calories. Eating a variety of:
Fruits
Vegetables
Whole grains
Low fat dairy products
Chicken / turkey
Fish
Nuts
Can also impact your cholesterol and
your blood pressure.
Limit your intake of red meat, sugary
foods and sodas.
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-andLifestyle-Recommendations_UCM_305855_Article.jsp
What changes do you need to make?
Making lifestyle changes and taking prescribed medicines can help you
prevent or control many risk factors and impact not just your diabetes, but
high blood pressure and high cholesterol as well.
Physical activity – aim for a goal of 30 mins of Cardio – walking or
stationary bike – aim for every day – don’t make excuses!
Take your medications as they are prescribed – speak to your provider or
your pharmacist if you have questions about your medications.
Making small changes to your diet – fruit and vegetables – look at local
options – markets, Produce box, grow extra in the spring and pre cook and
freeze for the winter
American Heart Association – is a great online resource
What questions do I need to ask my
provider?
1.
2.
3.
4.
5.
Know your numbers, ask what your Hemaglobin A1c is – you
would ideally like it below 6.5.
What are your cholesterol numbers? What is your goal? How do we
get to that goal?
What are the risks of not treating my heart or cardiovascular
disease?
Should I make lifestyle changes to improve my condition? What do
you recommend?
Will heart disease keep me from having a normal sex life?
PATIENT RESOURCES:
Where can I find resources to help me understand my diabetes and my
risk of heart disease?
NDEP – National Diabetes Education program
http://ndep.nih.gov/resources/heart-health.aspx
CDC – Center for Disease Control
http://www.cdc.gov/diabetes/home/index.html
AHA – american heart association
http://www.heart.org/HEARTORG/Conditions/Diabetes/Diabetes_UCM_001091_SubHomePag
e.jsp
NIDDK – National institute of Diabetes and Digestive and Kidney
disease
http://www.niddk.nih.gov/Pages/default.aspx
REFERENCES
http://www.niddk.nih.gov/Pages/default.aspx
www.heart.org/
www.ndep.nih.gov/
www.cdc.gov/
www.nih.gov/