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Diabetes and the Heart

Small blood vessels often show the first signs of damage related to diabetes. But larger vessels are also at risk. People with diabetes are at twice the risk for heart attack or stroke compared to people who do not have diabetes.

The presence of elevated glucose levels in the blood can cause irritation in the vessel, these areas of irritation make it easier for fat deposits called plaques to collect. These plaques block blood flow, increasing blood pressure. When this blockage is too large to allow sufficient blood flow to carry oxygen to an organ it is called an Ischemia. An ischemia in the heart is commonly called a heart attack or MI (myocardial Infarction/myocardial Ischemia), in the brain it is referred to as a stroke or CVA (cerebro-vasclar accident ).

A second issue that can lead to cardiac disease, and is worsened with diabetes, is High Cholesterol. Elevated blood sugar tends to cause good cholesterol HDL (that helps keep our vessels clear) to lower and bad cholesterol LDL (that forms plaques) to increase. So keeping blood glucose in range helps reduce cholesterol as well.

Reducing Risks for Heart Attack and Stroke

Consider ordering routine home BP checks weekly for people who are pre-hypertensive, and for hypertensive patients daily when well controlled, and multiple daily checks for those who have trouble maintaining controlled HTN.

Treat/prevent High Blood Pressure

CAC Scans

Manage Blood Glucose

Reduce Cholesterol

Nutrition consults

Consider statins/HDL supplementing

Routine Physical Inactivity

Smoking Cessation

Coronary Artery Calcium Scans have been shown to be the best way to calculate one’s cardiovascular risks. These should be considered for people with diabetes as well as other cardiac risk factors.

Manage your diabetes

Reducing blood sugars and maintaining time in target range will help you lower triglycerides, reducing cardiovascular risks! It will also make vessels more flexible, and less irritated and prone to injury.

Eating a diet that is low in LDL fats and high in HDL fats can reduce risks--nutrition consults are recommended. But this may not be enough for all patients to reduce their risks, so consider the risks and benefits of Statins, Fibrates, and or Fatty Acid supplements to help reduce LDL and increase HDL levels.

It is recommended that adults get 30 minutes of moderate physical activity at least 5 days a week as well as 2 days of resistance exercise. This can be as intense as going to the gym, taking a dance class or swimming, or as simple as taking a walk or playing with the kids!

Smoking increases blood pressure. Makes blood vessels tighter and more rigid, and causes blood sugars to rise. There is no single risk reduction measure that someone can do that is more beneficial than quitting smoking!

Diabetes and Dental Health

Our blood is not the only place that people with diabetes experience excess glucose. We also have excess glucose in our saliva, and produce less of it. Both of these increase risks for gum disease tooth decay and inflammation in people with diabetes.

Higher rates of Gum disease, infection, tooth decay and loss

Routine dental care improves quality of life and A1C!

Intensive treatment reduces A1C as much as adding medication!*

A 2018 study published in the Lancet Diabetes and Endocrinology journal followed 264 persons with type 2 diabetes for a year who had been diagnosed with gum disease (periodontitis). Half of the patients received standard dental care such as cleanings & tooth polishing; the other half received intensive treatment for gum disease. The participants who received intensive treatment showed a 0.6% reduction in their A1C over the year! That is the reduction one would expect from having added another diabetes medication! This means that dental treatment of gum disease can have as much impact on A1C as medication, with no side effects risks.