Diabetes type 2: Four ways you can prevent the condition from developing

From express.co.uk

DIABETES is an insidious condition, slowly taking away your energy, and causing internal damage when you're completely unaware you have it. This is why it's important to recognise the symptoms early - and to know how to prevent it from occurring in the first place

Early warning signs of type 2 diabetes include increased thirst, hunger and urination. Furthermore, fatigue, blurred vision and losing weight can all be symptoms of the condition. How can you prevent it from happening? The British Heart Foundation (BHF) warned high blood sugars – i.e. diabetes – tends to develop gradually "after the age of 40". It's closely linked to being overweight, being physically inactive and having a family history of the condition, such as a father or mother having it.

How to prevent type 2 diabetes

The first thing anyone can do to reduce their likelihood of developing type 2 diabetes is to be a non-smoker.

The Food and Drug Adminstration (FDA) said smokers have a 40 percent increased risk of high blood sugars.

The toxins in cigarettes cause harm to the body's cells, increase inflammation and decrease the effectiveness of insulin. Insulin is the key hormone, produced by the pancreas, that enables sugar to be converted into energy within the body.

When insulin doesn't work, the sugar remains in the blood, leading to type 2 diabetes (i.e. high blood sugar levels).

The BHF added that the second thing you can do to reduce your risk is to "manage your weight".

This is because obesity is one of the risk factors associated with developing type 2 diabetes.

Carrying too much fat around the abdomen increases insulin resistance, meaning your body is less efficient at converting sugar into energy. Too much sugar in the bloodstream can be dangerous, as it can damage the arteries and increased the chance of heart disease.

Maintaining a healthy weight – with a body mass index between 18.5 and 24.9 – can be achieved through diet and exercise.

This leads to the third and fourth lifestyle habits to help prevent type 2 diabetes.

The BHF encourages people to be "more active" in everyday life - essentially exercising daily.

The BHF is offering people the opportunity to sign up to My Step Challenge.

There you have the option of choosing your fitness goal, whether it be:

50k Step Challenge;

250k Step Challenge;

Half a Million Step Challenge;

Or creating your own challenge.

"Missing a day just means starting again tomorrow. Your health is worth the effort now and in the future," said the BHF.

As well as minimising the risk of type 2 diabetes, exercise can be seen as a miracle cure, preventing ill health.

The fourth – and final – lifestyle tip shared by the BHF to reduce the risk of diabetes is to "eat a healthy, balanced diet".

What is type 2 diabetes? (Image: Express)

There you have the option of choosing your fitness goal, whether it be:

• 50k Step Challenge;
• 250k Step Challenge;
• Half a Million Step Challenge;
• Or creating your own challenge.

"Missing a day just means starting again tomorrow. Your health is worth the effort now and in the future," said the BHF.

As well as minimising the risk of type 2 diabetes, exercise can be seen as a miracle cure, preventing ill health.

The fourth – and final – lifestyle tip shared by the BHF to reduce the risk of diabetes is to "eat a healthy, balanced diet".

Three tips for eating healthily

1. Eat plenty of fruit and vegetables
2. Choose wholegrain bread, rice, pasta and potatoes
3. Opt for low-fat, low-salt, and low-sugar

Try to eat – at least – five portions of fruit and vegetables every day; one portion is equivalent to one handful. Swap saturated fats (such as butter) for unsaturated fats (such as olive spread). And also refrain from adding salt to any of your cooking, or having salt on the dinner table.

https://www.express.co.uk/life-style/health/1415848/diabetes-type-2-prevention-not-smoking-diet-exercise-healthy-weight

Eat early to prevent Type 2 diabetes

From timesofindia.indiatimes.com

Early to bed and early to rise makes a man healthy, wealthy and wise. But, did you know that eating earlier can also make you healthier? If not then this study is for you.

A new research drove by The Endocrine Society found that intermittent fasting or eating earlier is associated with lower blood sugar levels and insulin resistance. People who start eating before 8:30 am had lower blood sugar levels and less insulin resistance, which could reduce the risk of developing type 2 diabetes.

“We found people who started eating earlier in the day had lower blood sugar levels and less insulin resistance, regardless of whether they restricted their food intake to less than 10 hours a day or their food intake was spread over more than 13 hours daily,” said lead researcher Marriam Ali, M.D., of Northwestern University in Chicago, Ill.

Insulin resistance occurs when the body doesn’t respond as well to the insulin that the pancreas is producing and glucose is less able to enter the cells. People with insulin resistance may be at higher risk of developing type 2 diabetes.

Both insulin resistance and high blood sugar levels affect a person’s metabolism, the breaking down of food into its simpler components: proteins, carbohydrates (or sugars), and fats. Metabolic disorders such as diabetes occur when these normal processes become disrupted. “With a rise in metabolic disorders such as diabetes, we wanted to expand our understanding of nutritional strategies to aid in addressing this growing concern,” Ali said.

Previous studies have found that time-restricted eating, which consolidates eating to a shortened timeframe each day, has consistently demonstrated improvement in metabolic health, she noted. Her group wanted to see whether eating earlier in the day affected metabolic measures.

The researchers analysed data from 10,575 adults who participated in the National Health and Nutrition Examination Survey. They divided participants into three groups depending on the total duration of food intake: less than 10 hours, 10-13 hours, and more than 13 hours per day. They then created six subgroups based on eating duration start time (before or after 8:30 am).

They analysed this data to determine if eating duration and timing were associated with fasting blood sugar levels and estimated insulin resistance. Fasting blood sugar levels did not differ significantly among eating interval groups. Insulin resistance was higher with shorter eating interval duration but lower across all groups with an eating start time before 8:30 am.

“These findings suggest that timing is more strongly associated with metabolic measures than duration, and support early eating strategies,” Ali concluded. 

https://timesofindia.indiatimes.com/life-style/food-news/eat-early-to-prevent-diabetes/articleshow/81733789.cms

Is Honey Safe for People With Diabetes?

From verywellhealth.com

Diabetes is a disease characterized by too high blood glucose, or blood sugar levels. Because of this, people with diabetes have to watch and manage their carbohydrate intake to help control their blood sugar levels.

Sugar is a carbohydrate many people with diabetes are told is “off limits” to them. However, there are many different types of sugar, and people with diabetes might wonder if some forms of sugar, such as honey, are better for them than white sugar.

Honey is a natural sweetener made by honey bees from nectar. It is composed primarily of water and the two sugars fructose and glucose, being between 30% to 35% glucose and about 40% fructose.

The remaining components are other sugars and a scant amount (about 0.5%) of vitamins, minerals, and antioxidants. Each tablespoon of honey contains about 17 grams of carbohydrates and 60 calories.

Comparatively, traditional white (table) sugar, or sucrose, is made up of 50% glucose and 50% fructose. White sugar contains 13 grams of carbohydrates per tablespoon, with no vitamins and minerals.

Rapeepong Puttakumwong | Getty Images

How Honey Affects Blood Sugar

Being a carbohydrate, it is expected that honey is going to impact blood sugar levels when consumed. However, when compared to other sugars, it may have less of an impact.

One study observed the glycaemic effect of honey compared to glucose in people with type 2 diabetes, measuring participants’ blood sugar levels at one and two hours after ingestion. Researchers found that with honey, blood sugar levels peaked at one hour, followed by a decline.

At two hours after ingestion of honey, blood sugar levels were lower than at the first hour. On the other hand, blood sugar levels with glucose ingestion were higher than with honey in the first hour and continued to rise even in the second hour. 

Because honey exhibited a shorter peak in blood sugar levels, it can be suggested that honey has a lower glycaemic effect than glucose. However, more research is needed to verify this claim.

Honey and Insulin

Some studies have shown that honey stimulates a greater insulin response than other sugars. Because of this, some people have speculated that honey is actually good for people with diabetes—and may even prevent diabetes.

Overall research on this topic has been conflicting, and more research with larger, long-term clinical trials are needed. Nevertheless, some studies do show promise. 

What Is Insulin?

Insulin is a hormone made in the pancreas that helps regulate blood sugar levels. When blood sugar levels start to rise, a signal is sent to the pancreas to release insulin.

Insulin then acts like a key and opens up cells to let glucose move from the bloodstream and into cells to be used for energy. In the process, blood sugar levels are lowered.

Depending on the type of diabetes, people with diabetes either no longer make insulin (type 1) or cannot use insulin properly (type 2). Glucose (sugar) remains in the bloodstream when there isn’t enough insulin or it isn’t being used properly by the body, resulting in high blood sugar levels.

In a small study of both people with type 1 diabetes and without diabetes, researchers found that honey had less of an effect on blood sugars in all participants compared to sucrose. Honey also raised participants’ levels of C-peptide. 

C-peptide is a substance made in and released by the pancreas, along with insulin. A normal level of C-peptide indicates the body is producing ample insulin.

A study of 20 children and adolescents with type 1 diabetes (patient group) and 10 children and adolescents without diabetes (control group) compared the glycaemic effect of honey to sucrose. Compared to sucrose, honey had a lower glycaemic effect in both groups.

C-peptide levels were not significantly higher in the patient group after using honey. However, C-peptide levels were significantly increased in the control group after using honey compared to sucrose. 

Honey Risks for People With Diabetes

Like any other sweetener, honey needs to be consumed in moderation due to its ability to increase blood sugar levels. If your diabetes is not well managed, it might be best to limit your consumption of honey. 

Since honey is sweeter than white sugar, you don’t need to use as much to get the same sweetness. When purchasing honey, be sure that honey is the only ingredient listed in the product, with no added sugars.

While honey contains some beneficial nutrients, you would need to consume more than is recommended for good health to get any significant amount from it. Do not consume large amounts of honey solely to get additional vitamins and minerals, as other sources of these nutrients will have much less impact on blood sugar levels.

Infants younger than 12 months should not be given honey due to the risk of infant botulism, which may be transmitted by both raw honey and pasteurized honey. There are no restrictions on honey for people age 1 and over, including those who are pregnant or breastfeeding. Adult intestinal toxemia botulism is extremely rare. 

Raw honey is typically unprocessed, while most honey found in the grocery store has been filtered and/or pasteurized. If you are concerned about foodborne illnesses, purchase pasteurized honey certified by a food inspector.

How to Safely Enjoy Honey With Diabetes

While natural, honey is still considered an added sugar in the diet. Nevertheless, it can be safely enjoyed by people with diabetes when consumed in moderation as part of an overall healthy diet. A diet rich in fibre from vegetables, fruit, whole grains, nuts, seeds, and legumes will help properly manage blood sugar levels.

Keep in mind the overall carbohydrate content of a meal when eating honey, as to not overdo it and cause hyperglycaemia. Be sure to balance any meal or snack containing honey with other nutritious foods lower in carbohydrates.

Some people prefer raw honey, which will not have any added sugars. Raw honey may have tiny amounts of pollen, while pollen and other solids are removed from filtered honey.

Replacing Sugar

If you are trying to get your diabetes under control and need to limit your intake of added sugar, consider using a sugar substitute such as stevia, xylitol, erythritol, monk fruit extract, or yacon syrup.

A Word From Verywell

Honey in moderation may be beneficial for people with diabetes, having a lower glycaemic effect than white sugar. Nevertheless, if you have diabetes, be sure to consult with your healthcare provider before adding honey to your diet. If your diabetes is not well managed, it might be best to limit honey and other added sugars in your diet.

https://www.verywellhealth.com/honey-and-diabetes-5115267

Taking Statins When You Have Diabetes

From verywellhealth.com

Statins are a type of medication used to lower cholesterol. As part of your regular diabetes care, your doctor will usually order blood tests to check for different metabolic abnormalities.

If your cholesterol is high your doctor may prescribe a statin as part of your healthcare regimen. They will help you weigh the risks and benefits of taking the medication to guide you in making the best decision for your health.

How Does Diabetes Affect Cholesterol?

Not only does diabetes affect your blood glucose levels, but it can also affect your cholesterol levels. Diabetes can lower HDL "good" cholesterol levels while increasing LDL "bad" cholesterol and triglyceride levels. This is called diabetic dyslipidemia, meaning your blood cholesterol results are going in the wrong direction.

Diabetic dyslipidemia can raise your risk for atherosclerosis, heart disease, and stroke. Research suggests an association between insulin resistance and diabetic dyslipidemia. Associations are also seen for atherosclerosis and blood vessel disease.

Insulin resistance occurs when your muscle, fat, and liver cells don’t respond well to insulin and can’t easily remove glucose from your blood. Insulin resistance often begins well before type 2 diabetes is diagnosed. Thus, associated cardiovascular conditions can develop even before you have diabetes.

Taking Statins with Diabetes

Statins work to lower cholesterol levels by blocking a substance your body needs to make cholesterol, therefore decreasing cholesterol made in your liver. They also help lower triglycerides and raise HDL “good” cholesterol.

Besides improving cholesterol, statins are also associated with a lower risk of heart disease and stroke, which are common comorbidities in diabetes. 

People with diabetes are twice as likely to have heart disease or a stroke compared to someone who doesn’t have diabetes—and at a younger age. The risk for developing heart disease increases the longer you have diabetes.

This is because, over time, high blood glucose levels cause damage to your blood vessels. This damage can obstruct the blood flow to your heart and brain, raising the risk of a stroke or heart attack.

Because of this increased risk, the American Diabetes Association (ADA) and the American Heart Association (AHA) recommend statin therapy in addition to lifestyle changes for the prevention of cardiovascular disease in people with diabetes, regardless of cholesterol numbers. Depending on age, disease status, and other risk factors, the ADA suggests differing intensity levels of statin therapy.

There are other risk factors for heart disease that can also be treated or modified. By doing so, your overall chances of developing heart disease may decrease. These risk factors include: 

• High cholesterol
• High blood pressure
• Being overweight or obese
• Smoking
• Heavy alcohol consumption
• Diet lacking in nutrient-rich foods
• Physical inactivity
• Stress

Do Statins Increase Blood Sugar?

Some research suggests that statin use increases blood sugar levels. A 2019 study published in Diabetes Metabolism Research and Reviews reported that statin users had a higher risk of developing new-onset type 2 diabetes. The risk increased the longer you took statins, with the greatest being in people taking statins for 2 years or longer. 

Research published in Cardiovascular Diabetology also found an association between statin use and a significantly increased risk of new-onset type 2 diabetes. Researchers noted a dose–response relationship, suggesting that a longer duration of statin use increased the risk even more.

Furthermore, the Women's Health Initiative study found that statin use increased the risk of diabetes in people after menopause. This large study mentioned that the increased risk appears to be a medication class effect, unrelated to dose or individual type of statin.

Due to the research and studies published regarding this risk, the Food and Drug Administration added a warning on statin labels to reflect the increased risk of higher blood sugar levels and new-onset diabetes when using statins.

Despite this increased risk, statin use is still indicated in many people with diabetes. This is because the decreased risk for stroke and heart attack outweighs the risk of higher blood sugars. Further, people who already have diabetes are not going to have diabetes caused by statins, because the diabetes already exists.

Nevertheless, always discuss with your healthcare professional the risks and benefits of taking statins as they relate to your individual risk factors and disease status.

Clare Jackson / EyeEm / Getty Images

What Statin Should You Take?

Your healthcare professional will take into account several factors when prescribing a statin. These include your cholesterol levels, risk factors you might have for heart disease, and your individual tolerance of the specific medication.

There are several statin medications, each with differing potency and dosage levels. As mentioned previously, the ADA recommends different intensity levels of statin therapy for people with diabetes, usually a moderate- or high-intensity statin.

Low-intensity statin therapy in people with diabetes is usually only recommended by the ADA only when higher-intensity therapy is not well tolerated.

Statin medications with a lower potency include Pravachol (pravastatin) and Altoprev (lovastatin). Moderate-potency statins include Zocor (simvastatin) and Lipitor (atorvastatin) at lower to moderate doses.

If your cholesterol is especially high, or you have several cardiovascular risk factors, your doctor may prescribe a stronger high-potency statin, such as Crestor (rosuvastatin) or atorvastatin at a higher dose.

How well you tolerate a statin is an essential factor when choosing which statin to prescribe. Depending on your doctor, they might start with a lower-potency statin and increase intensity later if your cholesterol levels do not improve enough.

Alternatively, they may opt to start with a higher potency statin, then adjust the type of statin or lower your dosage if it is not well tolerated.

Tell Your Doctor What Else You Are Taking

Always be sure to tell your doctor if you are taking any other medications, vitamins, minerals, or herbal supplements. Certain medications and supplements may negatively interact with statins, such as possibly decreasing the effectiveness of the statin or increasing statin concentrations in the blood.

Contact your doctor if you are experiencing any side effects from taking a statin. They may need to adjust your medication or dose to help minimize any negative side effects.

Some possible side effects of taking a statin include: 

• Muscle pain
• Headache
• Nausea
• Memory loss
• Higher blood sugar levels
• Sleep problems
• Lethargy

A Word From Verywell

If you are concerned about taking a statin, talk with your doctor about the pros and cons. They will help you weigh the risks and benefits as they relate to you. The benefit of preventing a heart attack or stroke often far outweighs the possible risks and side effects of statins. Never stop taking a statin without discussing it with your doctor first.

Maintaining healthy cholesterol and blood glucose levels is important to decrease your risk of heart disease. Medication alone is not enough to curb your overall risk, though.

Lifestyle changes, including quitting smoking, following a healthy eating pattern, and being physically active, are also critical in reducing cholesterol levels and managing diabetes.  Together, medication and healthy lifestyle habits can help you decrease your risk of developing heart disease while enjoying a great quality of life.

https://www.verywellhealth.com/statins-and-diabetes-5116077

Letting Go of Guilt When You Have Type 2 Diabetes

From healthline.com

• Many people with type 2 diabetes feel guilt and distress about their condition.
• Feeling guilty can be a barrier to managing diabetes.
• Practicing affirmations for diabetes and mindfulness are some of the ways to cope with guilt.

Type 2 diabetes is a very common disease in the United States. It impacts 13 percent of all adults in the country, according to the Centres for Disease Control and Prevention (CDC).

The prevalence of type 2 diabetes has sparked public health initiatives aimed at reducing cases and helping people with the disease manage their condition through diet and lifestyle changes.

While those campaigns are intended to be helpful, they can sometimes make people with type 2 diabetes feel guilty.

Guilt can come from feeling like you did something to cause the disease or that you’re not doing enough to manage it. That, in turn, can affect your mental health and make it more difficult to take care of yourself, so it’s important to find ways to cope.

Here’s what to know about guilt and type 2 diabetes, along with ways to let go of that feeling.

What’s the connection between guilt and type 2 diabetes?

Type 2 diabetes doesn’t just affect your physical health — it can also affect your emotional well-being.

A 2017 review of 55 studies found that 36 percent of people with type 2 diabetes experience distress related to their condition. Diabetes distress often includes feelings of guilt and shame.

That research echoed the findings of a 2013 study involving 25 adults with type 2 diabetes. Research found that self-blame and feelings of guilt were common among its 25 participants. One participant called it the “blame and shame disease.”

There are a couple of possible reasons why someone with type 2 diabetes might feel guilty about their condition.

Part of it might be from the stigma of the disease.

Research from 2017 on more than 12,000 people with the condition showed that 52 percent of people with type 2 diabetes felt that the disease came with stigma.

Some participants felt that others blamed them for causing the condition from eating too much, having a poor diet, not exercising enough, being overweight or having obesity.

Feeling like you’re not doing enough to manage type 2 diabetes can also cause guilt.

You might feel it when your doctor asks about how your diabetes management is going, if your haemoglobin A1C is too high, or if the number on the scale isn’t where you hoped it’d be if you’re trying to lose weight.

Understanding the root of your guilt can help you take measures to soothe those feelings.

How does guilt affect your health?

The emotional impact of diabetes can also affect your health.

A 2019 review called diabetes distress, which includes feelings of guilt, “one of the most common and important psychosocial barriers to effective diabetes care.”

Research from 2018 found that emotional distress from diabetes can lead to:

• lower quality of life
• higher risk of diabetes complications
• difficulty following treatment plans
• poor glycaemic management
• poor self-care

According to a 2017 study, people with diabetes face three times the risk for a major depressive disorder compared with the general population, largely due to diabetes distress and the feelings of stress and guilt it causes.

Earlier research showed that depression can add an extra layer of difficulty for people to manage type 2 diabetes.

Participants with both diabetes and depression were:

• more likely to smoke
• less likely to exercise
• less likely to get an annual dilated eye exam

When left unmanaged, type 2 diabetes can lead to serious health complications and even death.

Finding ways to help reduce feelings of guilt can make it easier to protect your health from long-term consequences of this disease.

How to let go of diabetes guilt

Feelings of guilt are common among people with type 2 diabetes. Fortunately, there are ways to cope with that emotion — or let it go altogether.

Here’s how.

1. Understand the facts about diabetes

A lot of the stigmas that can cause guilt come from a misunderstanding of diabetes. Learning how the disease works and can affect you over time can help give you a deeper understanding about the realities of living with the condition.

It’s important to note that type 2 diabetes is a progressive disease, meaning that it can get worse with time.

That means the things you’re doing right now to manage the condition may not work as well down the road, and you may need to make changes to your diabetes management plan.

For example, you may need to start using insulin at some point. This is a normal progression and not a sign that you did something you should feel guilty about. The ultimate goal is to get your blood sugar levels as close to a normal range as possible, and adjusting your treatment plan is part of that.

Likewise, learning the facts about what causes diabetes can help reduce self-blame and guilt.

Type 2 diabetes can be caused by a range of things that aren’t necessarily in your control, such as genes and biological factors (like insulin production and patterns of body fat deposition).

Keeping the truth in mind can be one step toward letting go of guilt.

2. Set realistic goals

Whether you’re trying to reach a healthy weight, exercise more, quit smoking, or adjust your diet, making lifestyle changes can help you manage your diabetes.

But if you don’t get the results you’re hoping for, you could end up with feelings of guilt and failure. Keeping your goals realistic helps set you up for long-term success.

Let’s take exercise as an example.

The National Institute of Diabetes and Digestive and Kidney Diseases recommends exercising at least a half hour per day for 5 days each week. That level of physical activity can be difficult if you’re just starting out and leave you feeling guilty if you can’t meet that goal.

Instead, set a smaller, more achievable goal. That might mean trying to get outside for a 10-minute walk most days for the next month.

As you hit your goals, gradually challenge yourself to increase your physical activity. Remind yourself of the effort you’re putting in along the way to combat feelings of guilt.

3. Practice mindfulness

Research from 2011 shows that people with disorders that involve excessive shame and guilt can benefit from mindfulness, especially when it emphasizes self-compassion and acceptance.

Mindfulness practices allow you to explore your thoughts and feelings without judgement.

Finding ways to stay in the present can help break the shame cycle that often accompanies guilt. That might mean simply focusing on your breath for a few minutes and noticing the thoughts that come into your mind.

You might also consider trying guided meditation that focuses on self-compassion.

Dr. Kristin Neff, co-founder of the Centre for Mindful Self-Compassion, offers a series of free guided meditations online that can help you get started.

4. Try affirmations for diabetes

Affirmations are positive statements that you say to yourself daily. Positive self-talk can reduce negative thinking and focus your brain on something helpful, ultimately helping to relieve guilt.

As you work to find an affirmation that feels supportive, explore statements that are personally meaningful to you or help put you in the mindset of how you’d like to feel.

Here are some examples of affirmations for diabetes to try:

• I trust my body.
• I’m the expert on my body.
• I’m doing my best.
• Taking care of myself is easy.
• I deserve to feel healthy.
• I enjoy exercising.
• I believe I can succeed.

These simple statements can shift your focus away from feelings of guilt or inadequacy toward achieving your goals.

5. Work with a therapist

A therapist or mental health professional can be a source of support in your journey to let go of diabetes guilt. They can help you develop strategies to challenge your thoughts and feelings around guilt.

Living with a chronic disease like diabetes can create stress that increases guilt and other negative emotions. Taking care of your mental health is an important part of taking care of yourself.

Takeaway

Many people with type 2 diabetes feel guilt about their condition. You might feel like you did something to cause your diabetes or that you’re not doing enough to keep it well managed.

Guilt can become a barrier to diabetes management, so it’s important to find ways to cope.

Understanding the facts of the disease, practicing mindfulness, and reciting affirmations for diabetes are some of the ways to start letting go of guilt.

Working with a mental health professional can also help you develop individualized tools for managing guilt and stress.

https://www.healthline.com/health/type-2-diabetes/diabetes-guilt

7 Things Certified Diabetes Educators Want You to Know About Managing Diabetes

From healthline.com

Taking care of yourself is an important part of managing type 2 diabetes.

It often involves making changes to your diet and lifestyle, developing a workout plan, taking your medications, and monitoring your blood sugar level throughout the day.

While managing diabetes can feel overwhelming at first, a certified diabetes care and education specialist (CDCES) can help set you up for success.

More commonly known as certified diabetes educators, these healthcare professionals specialize in educating, supporting, and promoting self-management of diabetes.

Certified diabetes educators work alongside people with diabetes to create customized goals that may help improve both care and health outlook.

Given their training and expertise, certified diabetes educators have unique insight to share about the condition. Here are the top things they want people to know about managing type 2 diabetes.

1. Setting realistic goals can help you stay on track

Keeping your blood sugar levels at a healthy level when you have type 2 diabetes may require you to make changes to your diet and lifestyle.

Figuring out exactly which changes you want to make can help you overcome obstacles along the way.

“Goal setting is a big part of successful diabetes self-care,” said Kerri Doucette, a certified diabetes educator and diabetes nurse specialist at Glytec, an insulin management software company.

The goals should be challenging yet realistically achievable. They should also be specific, so you know exactly what you’re working toward.

For example, a goal like “exercise more” is somewhat vague and hard to measure. A more concrete goal, such as “take a 30-minute bike ride 4 days per week,” helps you align your focus and make progress.

And if a particularly busy week is making it hard to achieve your goal, give yourself the flexibility to make adjustments, advised Doucette. The key is to figure out what you can realistically accomplish — then set a plan to make it happen.

“Be gentle on yourself when you need to be, but continue to work on smaller, more realistic goals for achieving a healthy lifestyle when life gets tough,” said Doucette.

2. Weight loss takes patience

Losing between 5 percent and 10 percent of your overall body weight can help make your blood sugar levels more manageable and potentially reduce your need for diabetes medication, according to the Centres for Disease Control and Prevention (CDC).

While you might want to change the number on the scale as quickly as possible, patience is key when it comes to weight loss, Doucette said.

“Rapid weight loss strategies may not be a long-term solution for maintaining your weight loss,” Doucette said. “Most patients I have worked with over the years were able to keep the weight off much longer when they lost weight slowly and steadily.”

People who lose weight gradually tend to have more success maintaining a healthy weigh in the long term, per the CDC.

That generally means about 1 to 2 pounds per week, but you can work with a healthcare professional or a registered dietitian to develop an individualized weight loss plan.

3. Your blood sugar doesn’t always have to be perfect

The American Diabetes Association (ADA) recommends that people with diabetes maintain a blood sugar level between 80 and 130 mg/dL before eating, and no more than 180 mg/dL an hour or 2 after the start of a meal.

That doesn’t mean you have to be in that range 100 percent of the time, though.

Spending about 70 percent of your day within the target range could lead to a haemoglobin A1C of 7 percent or less — the goal for most adults living with diabetes — said Diana Isaacs, a certified diabetes care and education specialist and remote monitoring program coordinator at the Cleveland Clinic Endocrinology & Metabolism Institute.

Staying within the target range at least 70 percent of the time “greatly reduces your risk of diabetes-related complications,” Isaacs said. “This is good news because it means that your blood sugars don’t have to be perfect to have good outcomes.”

4. Sleep can affect blood sugar levels

Sleep plays an essential role in maintaining both physical and mental health. For people with diabetes, getting adequate rest can also help control blood sugar levels.

“There are many factors that can cause blood sugars to rise, including lack of sleep, which puts additional stress on the body,” said Isaacs, “Getting a good night’s sleep of 7 hours or more can help keep your blood sugars better regulated.”

Getting a good night’s rest isn’t always easy for people with diabetes, though.

Research from 2017 found that many people with type 2 diabetes have a higher risk of sleep disorders, such as restless legs syndrome and insomnia.

Establishing healthy sleep habits, known as sleep hygiene, can help improve your ability to fall and stay asleep.

Here are a few ways to sleep better:

• Set a sleep schedule and stick to it.
• Avoid using electronic devices before bedtime.
• Limit your caffeine consumption late in the day.
• Use shades to block out light from your bedroom windows.
• Do relaxing activities, like taking a bath or journaling, before bed

5. Your diabetes management plan may change over time

Type 2 diabetes is a progressive condition. The changes your body goes through as you get older can impact the way you manage the condition and the risk of complications.

“It’s very common that medications are added over time,” said Isaacs. “It doesn’t mean that you did anything wrong.”

Rather than blaming yourself if medication stops working, work with your diabetes care team to adjust goals for managing your condition and explore other treatment options.

“Sometimes the pancreas is damaged and just can’t make the insulin it needs,” said Stephanie Redmond, a certified diabetes educator and doctor of pharmacy. “If this is the case, medications can be essential and even life saving to replace that insulin the body is missing, regardless of diet, exercise, or other lifestyle variables.”

6. You don’t have to give up carbs completely

When you consume carbohydrates, your body breaks the food down into glucose, a type of sugar. As a result, you tend to have a higher blood sugar levels after eating carbs compared with proteins and fats.

Decreasing the amount of carbs you eat can help you stay within your target blood sugar range, but that doesn’t mean you have to give them up completely, said Isaacs.

She recommended adjusting the ways you consume carbs to make them part of a more balanced diet.

“A good rule of thumb is to never eat a naked carb,” Isaacs said. “Foods like cereal, rice, pasta, candy, and potatoes raise blood sugar very quickly. Adding protein like chicken, eggs, meat, or tofu with carbohydrates will prevent blood sugar from spiking up as quickly

7. Some exercises can cause temporary spikes in blood sugar

Physical activity can be an important part of managing type 2 diabetes, but the way you move matters.

Certain exercises can increase blood sugar levels, said Redmond. Working out can also increase your body’s sensitivity to insulin, which can reduce your blood sugar for 24 hours or more, according to the ADA.

“Some workouts, although ultimately beneficial, may temporarily spike blood sugars,” Redmond explained. “Specifically high-intensity intervals like sprints or weightlifting and resistance training can release adrenaline, which can indirectly increase sugars.”

Redmond added that any exercise can help support sensitivity to insulin over time, but it’s important to be aware of the more immediate effects of working out on your blood sugar.

Takeaway

When it comes to developing a type 2 diabetes management plan, remember to consider different areas of your life that can all impact your overall wellness.

Sleep, nutrition, medication, and exercise are great places to start, but it’s important to understand that every person is different. What may work for someone else may not be right for you, and vice versa.

Consider working with a certified diabetes educator who can help you develop an individualized approach to managing your diabetes.

https://www.healthline.com/health/diabetes/tips-from-diabetes-educators

Breakfast Timing Could Affect Your Odds for Type 2 Diabetes

From consumer.healthday.com

MONDAY, March 22, 2021 (HealthDay News) -- Could the time you eat your breakfast determine your health?

Yes, suggests new research that finds eating your morning meal before 8:30 a.m. may reduce your risk for developing type 2 diabetes.

People in the study who ate breakfast early had lower blood sugar levels and less insulin resistance than folks who ate a later breakfast. Insulin resistance occurs when your body becomes resistant to the effects of the hormone insulin, causing blood sugar levels to rise.

The new findings held regardless of whether people restricted their eating to less than 10 hours a day or spread it out over windows of more than 13 hours.

Such time-restricted feeding is a form of intermittent fasting, which is all the rage these days due to a laundry list of potential health benefits ranging from weight loss and lower risk for disease to longevity. People who practice time-restricted eating typically eat during an eight to 12-hour daytime window and fast during the remaining 12 to 16 hours.

However, the new study suggests it is not the duration of the window, but the timing of the meals that may matter most when it comes to diabetes risk.

"Timing is what's important, and earlier seems to be better," said study author Kristen Knutson, an associate professor at the Centre for Sleep and Circadian Medicine at Northwestern University's Feinberg School of Medicine in Chicago. "Our ability to process the food we eat works better in the morning."

To find out if the duration of the window or the timing of the meals was more important, researches divided more than 10,570 adults from the National Health and Nutrition Examination Survey into three groups based on their windows of eating (less than 10 hours, 10-13 hours, and more than 13 hours per day). Participants were further sorted by the time of day that they began eating -- whether before or after 8:30 a.m.

And the study found it was the timing, namely earlier breakfasts, that made the most difference in insulin resistance and blood sugar levels, though only an association was seen.

The next step is to see if earlier windows of time-restricted fasting, say 8 a.m. to 4 p.m., promote greater benefits, Knutson said. "Indeed, earlier time-restricted feeding may be better than later, and the next step would be an intervention to test whether moving the feeding [even] earlier in the day has beneficial effects," she said.

Knutson practices what she preaches. She wakes up every day around 7 a.m. and eats breakfast. "On days that I consider skipping breakfast, I don't because of studies like these," she said.

The study didn't look at what people ate for breakfast, but it stands to reason that healthier choices such as whole-grain cereals unlock even greater benefits, Knutson said.

The study will be presented this weekend at the Endocrine Society's virtual annual meeting. Such research is considered preliminary until published in a peer-reviewed journal.

Krista Varady, a professor of nutrition at the University of Illinois in Chicago, studies intermittent fasting, including time-restricted fasts.

The new findings make sense, said Varady, who was not involved with the research. "You are better at processing glucose or blood sugar early in the morning, and this ability wears down as the day goes on," she said.

There are benefits seen with time-restricted feeding on weight, diabetes risk and other diseases. And "there may be even more benefit to earlier windows, say 8 a.m. to 4 p.m. versus 12 p.m. to 8 p.m.," Varady said.

But these earlier windows may not work well within many people's lifestyles, she said. "No one really wants to skip dinner, so it may not be so appealing," Varady said. "If you eat earlier, it's probably better for you, but it's highly unlikely that people will want to shut the window that early."

If you can't maintain this way of eating, the benefits will be lost, Varady said.

Still, more research is needed before any firm conclusion can be drawn about the best windows for time-restricted feeding, "We are running studies and waiting for that data to see whether early versus late time-restricted feeding shows greater benefits," Varady said.

https://consumer.healthday.com/3-19-breakfast-timing-could-affect-your-odds-for-diabetes-2651083624.html

The surprising relationship between blood pressure and diabetes

From mlive.com/news

By Denise Provencher

JACKSON, MI – On their own, diabetes and high blood pressure can pose serious health risks, including kidney failure, stroke and heart disease. But there is a relationship between the two that, when compounded, can pose even greater complications.

Uncontrolled diabetes damages arteries and makes them more prone to hardening and calcification, resulting in high blood pressure. When arteries harden, they are not elastic, and pressure increases. Likewise, high blood pressure – along with obesity and low HDL (heart healthy) cholesterol – contributes to metabolic syndrome, also known as pre-diabetes, which increases the risk of diabetes.

Good blood flow is crucial to our health, and uncontrolled diabetes can cause narrowing of capillaries and, ultimately, tissue damage. Because blood goes everywhere in our bodies, impaired blood flow can affect our brain, heart, eyes, kidneys and nerves – every organ and cell.

Both diabetes and high blood pressure, if not properly controlled, lead to serious complications. Maintaining healthy blood pressure and treating diabetes are vital to staying well and reducing risks of kidney failure, blindness, heart attack, stroke, and death.

It’s important to lower your risk of diabetes and high blood pressure by partnering with your doctor to maintain your health. Here are some ways to stay healthy:

Exercise regularly: While some may cringe when they hear the word “exercise,” getting active doesn’t require you to run a marathon. Start by building more movement into your daily routines, whether that’s walking around the block or getting up from your desk to walk around the room a few times each hour. For those with both diabetes and hypertension, walking just 15-20 minutes a day can be beneficial. Weightlifting builds muscle, which also helps burn fat and fight obesity.

Eat healthy: Changing your diet is crucial to fighting obesity, and limiting sugars and carbohydrates is key to managing diabetes. Limiting sodium when you have high blood pressure can help control those levels. Talk to your doctor to determine your ideal daily calorie count and aim for a balanced diet. Limit fast food to an occasional treat. Get plenty of fruits and vegetables, as well as the proper amounts of proteins (lean meats and fish) and whole grains. Increasing fibre in your diet often helps with diabetes as well.

Increase your (good) cholesterol: Many people think that avoiding high cholesterol is key to maintaining health, but it’s more complicated than that. Not all cholesterol is created equal. HDL cholesterol is good for your heart, and increasing that level will help protect your heart. Keeping LDL cholesterol low is also important. Avocados and olive oil can increase HDL cholesterol, as can beans (legumes), fresh fruits, vegetables, nuts (handful) and fish. These are staples of the Mediterranean Diet, a good general diet to strive for. Search online for easy and delicious recipes.

Focus on self-care: Caring for yourself and treating stress can help keep your blood pressure low. Take a few minutes each day to meditate, sit with a good book and herbal tea, or turn to a calming hobby. Taking care of your mental health can have major benefits on your physical health.

Talk to your doctor: It’s important to schedule annual physicals, even if you’re in perfect health. However, it’s even more crucial to have follow-up visits and partner with your physician if you’ve been diagnosed with high blood pressure or diabetes. Monitoring and maintaining healthy blood pressure levels and blood sugar is crucial to preventing serious conditions. Learning about your disease can also be beneficial. Everyone is different; talk to your doctor to create a plan for maintaining your health.

– Denise Provencher, Physician Assistant, works at the Center for Family Health - Northwest School Health Center

https://www.mlive.com/news/jackson/2021/03/center-for-family-health-column-the-surprising-relationship-between-blood-pressure-and-diabetes.html

Learn if you’re at risk for type 2 diabetes

From winchestersun.com

CLARK COUNTY HEALTH DEPARTMENT

March 23rd is Diabetes Alert Day, an annual opportunity to encourage Americans to learn their risk for developing type 2 diabetes. Did you know that one in three Americans has prediabetes, a condition that means their blood sugar levels are higher than normal, but not yet high enough for a diabetes diagnosis?  As such, 90% of people with prediabetes do not know they have it.

     Luckily, there’s an easy screening test that can help people learn if they are at risk. The test can be found at doihaveprediabetes.org and only takes 60 seconds to complete. By answering simple questions such as, “Are you physically active?” and “Do you have a family history of diabetes?” participants can quickly learn their risk score. This year for Diabetes Alert Day, we’re hoping to get as many people as possible to take the test.

There is one thing to keep in mind for our community, the Clark County Health Department offered the Diabetes Prevention Program before COVID-19, a lifestyle change program that is recognized by the Centres for Disease Control and Prevention (CDC). Studies show that people with prediabetes who take part in the CDC’s National Diabetes Prevention Program lifestyle change programs can cut their type 2 diabetes risk by 58 percent. 

Risk factors, statistics and resources

• Risk factors for type 2 diabetes include gender, family history, high blood pressure, age, physical activity, and body mass index. Add audience-specific information if this will help to better connect with the news outlet’s audiences.

• The website for the prediabetes risk test is doihaveprediabetes.org. It only takes one minute (or less) to complete the test, and it can be printed out.

• 84 million Americans – or one in three – has prediabetes. Someone has prediabetes when his or her blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes. Ninety percent of people who have prediabetes don’t know they have it. Prediabetes can often be reversed with healthy lifestyle changes.

• Studies show that people with prediabetes who take part in the CDC’s National Diabetes Prevention Program lifestyle change programs can cut their type 2 diabetes risk by more than 50 percent.

• Do your part to stay healthy!

https://winchestersun.com/2021/03/19/learn-if-youre-at-risk-for-diabetes/

6 easy breakfast ideas recommended by dietitians for people with diabetes

From insider.com

This article was medically reviewed by Kailey Proctor, MPH, RDN, CSO, a board-certified oncology dietitian at the Leonard Clinical Cancer Institute with Mission Hospital

Top your oatmeal with healthy fats and carbs like peanut butter, chia seeds, and fruit.

vaaseenaa/Getty Images

• Healthy breakfast ideas for those with diabetes include avocado toast, oatmeal, and an egg sandwich.
• If you have diabetes, make sure breakfast has a combination of protein, fats, and carbohydrates. 
• Breakfast is especially important for diabetes as it can help manage blood sugar levels all day. 

Breakfast is perhaps the most important meal of the day for people with diabetes because it can help stabilize blood sugar levels which are typically at their highest right after waking up. It can also prevent major blood sugar fluctuations for the rest of the day. 

But there's a difference between incorporating breakfast into your diet and creating a balanced breakfast that works best for you, says Kara Wood, RD, a dietitian at the University of Iowa Hospitals and Clinics. Some breakfast ingredients and options are healthier than others. 

Here are six easy breakfast ideas for people with diabetes. 

1. A breakfast sandwich

This sandwich will give you necessary carbohydrates while protein from the egg keeps you full without spiking blood sugar levels. A study in 2018 found people who ate an egg every day had reduced fasting blood sugar levels.

How to make it: Key ingredients include one whole-wheat English muffin, an egg, one slice of cheese, and one ounce of meat of your preference, says Wood. Along with this, you can also include ¾ cup of blueberries for added fibre or avocado slices for heart-healthy fats. 

2. Oatmeal

Oatmeal contains carbohydrates, fibre, and protein. A large 2015 study found oats are beneficial to patients with type 2 diabetes due to their effect in decreasing blood sugar levels and cholesterol. 

How to make it: With one cup of cooked oatmeal, add eight ounces unsweetened almond milk, one tablespoon of chia seeds, three tablespoons of walnuts, two tablespoons peanut butter powder, and a cup of strawberries on top. 

3. Avocado Toast

The healthy fat from avocado slows digestion and keeps carbohydrates — which are normally processed quickly by the body — from absorbing into the bloodstream rapidly, says Cassandra Vanderwall, RD, a Clinical Nutritionist at UW Hospitals and Clinics. 

How to make it: Vanderwall suggests a piece of whole-wheat toast, a sliced half avocado, and an egg for breakfast. 

4. Cereal

If you have diabetes, you can still eat cereal for breakfast, but opt for a high fibre, whole grain cereal rather than a sugary, sweetened one, says Wood. Wholegrain cereals can aid in managing blood sugar levels by releasing glucose at a much slower rate thanks to their fibre content.  

How to make it: Include additional food groups to the meal like a hard-boiled egg or peanut butter for a boost of protein. 

5. Yogurt Parfait 

Plain yogurt has few carbohydrates, says Wood, and it's high in protein, so it won't cause blood sugar levels to spike like other carbohydrates may. Some yogurts also contain probiotics, which lower fasting blood sugar and insulin level. 

How to make it: For this breakfast, use eight ounces of unsweetened, plain Greek yogurt with a half cup pecans, one tablespoon of flaxseeds, one tablespoon of almond butter, and a cup of mixed berries, says Wood. 

6. Trailmix

If you are in a rush in the morning and looking for a more grab-and-go option, Vanderwall says trail mix can be a good choice. This can include nuts for protein, small amounts of dried fruit, such as cherries or raisins, and you can throw some whole-grain cereal in the mix as well. 

For dried fruit, it is important to keep the portion sizes low since they are high in sugar which spikes blood sugar. Generally, a good portion size is around 2 tablespoons. 

How to make it: This recipe includes 1 cup multi-grain cheerios, ¾ cup almonds, and a third cup of dried cherries. You can also add mini-chocolate chips if you'd like.

Foods to avoid with diabetes

For people with diabetes, no food is completely off-limits, says Vanderwall. The real question is how much and how often. Some foods can increase your chances of high blood pressure, high cholesterol , and uncontrolled sugar, she says. 

Some examples of foods you may want to avoid include: 

• Sweetened drinks, such as soda or a sugary cappuccino coffee
• Packaged meats
• Sugary cereals
• Fried foods
• Whole milk

"[People with diabetes] don't have to avoid fruit," says Wood. "It's all about balance. If you really want an orange or a banana, which might spike your blood sugar, eat some protein and fat along with it to keep your levels stable."

Insider takeaway

Breakfast is a very important part of the day for someone with diabetes. Eating in the morning can keep your blood sugar levels under control and stable throughout the day. 

Easy breakfast options, such as oatmeal, avocado toast, or a yogurt parfait, will give you the balanced meal you need with variations of carbohydrates, protein, and healthy fats. While there may be some foods to avoid if you have diabetes, what's more important is to keep your breakfast balanced and nutritious so you can avoid any unnecessary blood sugar fluctuations. 

https://www.insider.com/diabetic-breakfast

Can People With Diabetes Eat Chocolate?

From healthline.com

Living with diabetes means that you’re constantly aware of your food and drink intake, and the impact of the foods you eat on your blood sugar levels.

Many people think that if you have diabetes, you can’t have sweets or chocolate — but in reality, that’s a myth. You can still have these foods in small amounts, but they need to be part of a larger healthy lifestyle and diet.

By choosing high-quality dark chocolate — 70 percent cocoa — you get a stronger chocolate taste, which can help you eat less. Check the labels for carbohydrate contents to help you adjust insulin levels, and you can enjoy a sweet treat.

Talk with your doctor about whether you can incorporate chocolate into your diet, in moderation.

Benefits and drawbacks of eating chocolate

In addition to satisfying a craving, there may be health benefits to eating chocolate, especially dark chocolate.

Potential benefits

A group of plant chemicals called flavonoids may help reduce insulin resistance and improve insulin sensitivity. Dark chocolate may also help reduce clotting in the blood.

Flavonoids in dark chocolate may also improve endothelial function, causing the reduced insulin resistance, and also reducing the risk of future cardiovascular problems.

The endothelium is a membrane that lines the heart and blood vessels. When there is endothelial dysfunction, there is a higher risk of heart attack and stroke.

Drawbacks

All chocolate is not the same — milk and white chocolate don’t have the same health benefits as dark chocolate. Eating foods like chocolate cake or chocolate chip cookies will not provide the benefits as, say, a small square of dark chocolate.

Eating too much chocolate can cause issues with blood sugar and weight gain.

A balanced diet

When you have diabetes, eating a balanced diet is important. It is not only part of an overall healthy lifestyle, but it’s also part of your treatment plan. Along with regular physical activity, having a balanced, healthy diet can help keep your blood glucose level in the normal range and keep your weight stable.

A healthy weight can help control your blood sugar levels and reduce your risk of diabetes complications.

Diabetes can typically be controlled by a combination of:

• monitoring what you eat and drink
• regular physical activity
• taking prescribed diabetes medications

A balanced diet includes:

• vegetables
• fruits
• whole grains
• lean protein
• low-fat dairy

Include heart-healthy fats like:

• olive oil
• nuts and seeds
• fish
• avocado

Try to limit saturated and trans fats, processed grains like white rice, and high glycaemic index foods.

Healthier chocolate recipes

When you really want chocolate or something chocolate-flavoured, there are ways to make sweets and desserts healthier. Check out the Diabetes Food Hub from the American Diabetes Association for ideas. Turns out you can have your cake, and eat it, too!

• Chocolate cake: If you’re in the mood for cake, check out this recipe for gluten-free chocolate mug cake. It contains fibre to help regulate your blood glucose level while still providing the taste of chocolate.
• Peanut butter and chocolate: If you’re in the mood for this classic combination, try out these no-bake peanut butter and chocolate bites.
• Cookies: Sometimes you just want classic chocolate chip cookies, and these gluten-free quinoa chocolate chip cookies will provide you with high-fibre chocolate chip goodness.

Note: While many of these recipes are gluten-free, people with diabetes do not need to avoid gluten unless diagnosed with celiac disease.

Why lifestyle changes matter

Keeping your blood sugar level in target range is an important part of managing diabetes, and along with medication, diet and exercise, can help. All of these things work together to create optimum health and prevent complications from diabetes. Diet and exercise can help:

• stabilize your blood sugar, cholesterol, and blood pressure
• keep your weight in a healthy range or help you lose weight
• prevent or delay complications from diabetes
• give you more energy
• improve blood flow
• burn extra calories
• improve your mood

Your diet may depend on your insulin or other diabetes medications, and your healthcare team can work with you on the best times to eat, your carbohydrate intake, and meal planning questions you might have.

It’s not easy making lifestyle changes, but you don’t have to do it alone. You don’t have to deprive yourself of chocolate or sweets, and your healthcare team can help you find a way to incorporate these foods into your diet in a healthy way.

https://www.healthline.com/health/diabetes/chocolate-for-diabetics#lifestyle-changes

Diabetes and heart disease: What is the connection?

From medicalnewstoday.com

Research suggests a strong link between diabetes and heart disease. The conditions share many of the same risk factors, including obesity, high blood pressure, and high cholesterol.

Research has also discovered specific biological mechanisms associated with diabetes that increase the risk of heart disease.

Heart disease and stroke are the leading causes of death in people with diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Indeed, adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. High blood sugar levels in people with diabetes may damage blood vessels, increase inflammation, and disrupt the normal blood flow in the heart.

Therefore, it is important for people with diabetes to reduce heart disease risk by managing their blood sugar, blood pressure, and cholesterol levels, eating a healthy diet, getting regular exercise, and taking medications as prescribed.

What is heart disease?

Heart disease refers to a group of conditions that affect the heart. It is the leading cause of death in the United States. In fact, it is responsible for roughly 1 in every 4 deaths, according to the Centres for Disease Control and Prevention (CDC).

The most common type of heart disease is coronary artery disease. It develops over time as the arteries that supply blood to the heart fill with plaque, which is made up of cholesterol and other substances.

Plaque causes the arteries to harden and narrow. This is known as atherosclerosis.

Narrowing of the arteries reduces blood supply to the heart, starving it of oxygen and nutrients. This causes the heart muscle to weaken over time, increasing a person’s risk of heart failure, heart attack, and other heart issues.

What is the connection?

According to the American Heart Association (AHA), adults with diabetes are two to four times more likely to die from heart disease than those without diabetes.

People with diabetes often have many of the same risk factors associated with heart disease, including:

• Having high blood pressure (hypertension): The AHA also say that having both hypertension and diabetes doubles a person’s risk of heart disease.
• Having unhealthy cholesterol and triglyceride levels: This contributes to a build-up of plaque in the arteries and is a major factor in developing insulin resistance.
• Having obesity, or a body mass index (BMI) over 30: Weight loss in people who have both obesity and diabetes can reduce cardiovascular risk and increase insulin sensitivity.
• Not getting enough physical activity: Exercise helps:
  • maintain a moderate body weight
  • reduce blood pressure
  • support healthy blood sugar levels and lower A1C levels
  • reduce the risk of type 2 diabetes, heart attack, and stroke
• Eating an unhealthy diet: Diets associated with both heart disease and diabetes are high in:
  • refined grains
  • added sugars
  • salt
  • saturated and trans fats
  • processed foods

How diabetes affects the heart

High sugar levels in the blood of people with uncontrolled diabetes can damage blood vessels over time. It can also damage nerves throughout the body, including those that control the heart and blood vessels.

Some studies suggest high blood sugar may increase inflammation in the blood vessels and disrupt normal blood flow in the heart. Long-term inflammation in the arteries results in a build-up of cholesterol and plaque. This means that the heart has to work harder to pump blood.

The longer a person has uncontrolled diabetes, the higher their risk of heart disease. Managing blood sugar levels reduces a person’s risk of complications.

Research in mice also suggests that people with diabetes may have lower levels of two enzymes that work to control the production of nitric oxide. Nitric oxide is a gas that relaxes the blood vessels.

These findings could eventually lead to new drugs for heart disease and diabetes aimed at preventing vascular damage. For now, however, more research is necessary.

Best diet for heart disease and diabetes

Eating for diabetes and heart disease prevention involves choosing foods that reduce blood pressure, overall cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting blood sugar levels.

In general, foods that are best for managing heart disease and diabetes are:

• low in:
  • sodium
  • cholesterol
  • saturated fats (and free of trans fats)
• high in:
  • antioxidants
  • vitamins
  • minerals
  • fibre

When grocery shopping, try to choose plenty of fresh, whole foods. Also, try to limit processed or packaged foods, which may be high in salt or sugar.

Some examples of good food choices include:

• fresh fruits
• fresh vegetables
• low fat dairy
• brown rice
• legumes, such as chickpeas or lentils
• whole grain bread or pasta
• healthy fats, such as those in olive oil, avocados, nuts, and seeds
• lean protein, such as skinless chicken, lentils, eggs, and fish

A registered dietitian can offer advice to manage weight and eat healthily for heart disease and diabetes.

Testing for heart disease

There is no single test that diagnoses heart disease. A doctor will likely conduct a variety of tests to understand a person’s overall metabolic health. These tests may include:

• Blood tests: These check total cholesterol, LDL cholesterol, high-density lipoprotein cholesterol, and triglycerides (a type of fat in the blood).
• Echocardiograms: These use sound waves to produce images of the heart to see how well blood moves through it.
• Transesophageal echocardiography (TEE): This also uses sound waves to get a picture of the heart. With TEE, a doctor can assess a person’s heart valves and check for blood clots.
• Electrocardiograms (EKG): These measure the electrical activity of the heartbeat to look for any irregularities. With an EKG, a doctor can understand if a person’s heart is working too hard or if they’ve recently had a heart attack.
• CT or CAT scans: These use a computer to produce cross-sectional images of the heart.
• Stress tests: These can assess the heart’s response to exercise.

How to take care of the heart with diabetes

Managing blood sugar, blood pressure, and cholesterol levels is the most important way for a person with diabetes to take care of their heart. They can usually achieve this through diet, medication, exercise, and other lifestyle modifications.

Diet is essential in managing blood sugar levels. A person should try to focus on eating lots of fresh fruits, vegetables, whole grains, legumes, lean protein, and low fat milk. They should also try to limit processed, sugary, and fatty foods.

Medication is also recommended for some people. In clinical trials, many newer diabetes medications have significantly reduced the risk of heart disease and stroke.

For people with type 2 diabetes who are at higher risk of heart disease, the recently updated American Diabetes Association guidelines recommend that doctors prescribe sodium-glucose cotransporter 2 inhibitors, such as empagliflozin (Jardiance), or glucagon-like peptide 1 receptor agonists, such as liraglutide (Victoza).

A doctor may also recommend medications such as aspirin to reduce blood pressure, lower cholesterol, and prevent blood clots.

It is also critical for those who currently smoke to stop smoking.

For overall heart health, the AHA recommend getting at least 150 minutes of moderate intensity aerobic activity or 75 minutes of vigorous aerobic activity per week.

Moderate intensity aerobic activity includes such activities as:

• brisk walking
• dancing
• tennis
• cycling at a speed slower than 10 miles per hour (mph)

Examples of vigorous activities include:

• hiking uphill
• jogging
• cycling at a speed faster than 10 mph
• swimming laps

People should also aim to do a full-body muscle-strengthening activity, such as weight lifting or Pilates, at least 2 days per week.

Overall, a person should try to spend less time sitting. Over time, the goal is to increase the amount and intensity of physical activity.

The takeaway

There is a strong link between diabetes and heart disease. These conditions share common risk factors, including high blood pressure, high cholesterol, obesity, and more.

Over time, uncontrolled high blood sugar can damage the blood vessels and nerves that control the heart.

People with diabetes can significantly reduce their risk of heart disease by losing weight (if they have obesity or overweight), increasing physical activity, eating fresh, healthy foods, and taking prescribed medications.

https://www.medicalnewstoday.com/articles/diabetes-heart-disease-connection#takeaway