It is frightening how many people do not know that there is a connection between Diabetes and the Heart. Diabetes alone is a significant risk factor for heart disease. Considering that Heart Disease is Number one killer in the world, and Diabetes is the Second, where does that leave us here in Botswana. Dr Nyarko of World Health Organization, at a recently held World Heart Day in Botswana, noted that “When it comes to dealing with chronic non-communicable diseases like diabetes, we are not yet there, and we really need to accelerate and increase our efforts as this disease is rapidly increasing in our populations.” 

How does diabetes affect the heart?

1.  High sugar levels in the blood affect the walls of the arteries making them more likely to develop fatty accumulation (atheroma).
2. Diabetes works together with other risk factors such as high blood pressure and smoking together with high cholesterol to worsen damage to the coronary blood vessels (the circulation to the heart itself).
3. People with diabetes are more likely to have high blood pressure
4. Diabetes can affect the heart muscle itself making it a less efficient to pump
5. Diabetes can affect the nerves to the heart so the symptoms of angina (chest pain) may not be felt in the usual way. This leads to delay and difficulties in diagnosing heart problems and ultimately heart attack.

 Dr Churchhill Onen, Chairman of the Diabetes Botswana and Senior Consultant Physician stressed that the most effective prevention strategy

This is true of Heart Disease as well, and in fact a healthy lifestyle can ward off many, many diseases and stresses that are really unnecessary in this already challenging life.

Lets look at a few things we can do:

 As a Diabetic, what can I do to reduce my risk of heart disease?

 Diabetes alone is considered as a significant risk factor for heart disease.  So if you have diabetes you would likely be given medicines to reduce your risk of heart disease (such as aspirin).

 Controlling blood sugar and blood pressure very well is essential for preventing the long-term complications of diabetes.  However this is often not enough to prevent heart disease. The major risk factors for heart disease need to be controlled by a combination of very effective treatment and appropriate lifestyle.

Be more physically active

 If you already have diabetes, then physical activity may help reduce the amount of tablets or insulin that you need to take.  The aim is to gradually increase your physical activity until you are doing 30 minutes of moderate activity at least five days a week.  Walking is one of the best forms of activity.  It is easy to do, you don’t need to wear any special clothes and it is easy to fit into your everyday life.  If your diabetes is treated with insulin or tablets, you may find that your blood sugar level falls quickly during or after exercise.  It is very important to monitor your blood glucose carefully as you start to build up your level of physical activity because you may need to change the dose of your medication.

 Stop smoking

 Smoking cigarettes is particularly dangerous and multiplies your risk of heart disease if you have diabetes.  The most important thing that you can do to live longer is to stop smoking. 

 Control your cholesterol levels

 A healthy diet will help to reduce your cholesterol levels.  You need to reduce the saturated fat and replace it with moderate amounts of mono-saturated fats and poly- unsaturated fats.  Saturated fat is found mostly in meat and dairy products.  Reduce the total amount of fat that you eat. 

 Doing regular physical activity can also help reduce your cholesterol levels.

 If you have diabetes you may well need to take a statin drug to reduce your cholesterol levels and perhaps a fibrate drug to control your triglyceride levels.  For more information on cholesterol and healthy eating see one of our previous newsletters

 Controlling high blood pressure

 High blood pressure is common in people with diabetes and it is essential to control it.  Ensure that your blood pressure is below 130/80mmHg or lower, if you already have kidney complications.

 Weight control

 If you are a man you should aim for a waist circumference less than 90 cm and if you are a woman you should aim for a waist circumference of 80 cm.  This is a quick and easy way to find out how much weight you need to loose.

 Appropriate lifestyle measures

 Fruits and vegetables are good with nutrients that help lower your risk of heart disease.  However there is no evidence that taking vitamins, mineral supplements or other remedies have the same effect.