If You Have Diabetes

The fight for a healthy heart is even more important for people with diabetes than it is for people without. According to the American Diabetes Association, over a ten-year period, people with diabetes have a 15 percent to 25 percent chance of developing heart problems, and more than 65 percent of people with diabetes die from heart disease or stroke.

Experts don't fully understand why diabetes causes cardiovascular disease, but it's clear that people with diabetes—especially type 2 diabetes—often have various heart disease risk factors, such as high cholesterol, high blood pressure, high triglycerides, and obesity. Diabetes also tips the balance of good and bad cholesterols in an unhealthy direction. Most diabetics have low HDL and high triglyceride levels and many have LDL levels above the current 100 mg/dL target goal. The high blood sugar associated with diabetes may have another negative affect on cholesterol—it may be responsible for accelerating the chemical change known as oxidation of LDL cholesterol. Many scientists suspect that oxidized LDL cholesterol plays a key role in initiating the inflammatory damage that causes atherosclerosis.

It's especially important for people with diabetes to limit their 194 intake of foods with high cholesterol or saturated fat content.

Differences Between the Sexes on Cholesterol?

For a long time, medical studies didn't include women because researchers were afraid that their menstrual cycle would skew results or that the subjects would become pregnant and have to stop taking a medication. Younger women were also less likely to have heart disease, which meant more participants would have to be included to be able to show a difference in outcomes if women were involved. More study subjects means more money to do the study, so leaving women out was a practical decision that wasn't as sexist as it sometimes appears.

Fortunately, once the benefit of a particular therapy was shown in men, the economics made it favorable to study women as well, and later studies have shown that women benefit just as much as men do from cholesterol-lowering interventions, whenever the risk is equivalent. By the time women are in their midsixties, their risk of new coronary events is similar to that of similarly aged men, so there should be little difference in treatment at that point. In younger, premenopausal women, the risk for heart disease is less than that of men, so fewer women in this age group require treatment. However, when all risk factors are taken into account, men and women of equivalent risk for heart disease get treated to the same LDL target goals.

However, even if you follow a strict diet and exercise program, it's likely that you won't be able to get your cholesterol under control without medication. Don't think this is a free pass to pop a pill and ignore your diet, however—it's especially important for people with diabetes to pull out all the stops in terms of cholesterol control.

The 2004 NCEP guidelines stress the importance of controlling cholesterol if you have diabetes. The panel notes it is reasonable for people with both diabetes and heart disease to strive for the very low LDL level of 70 mg/dL. For people with diabetes ,195

who don't have a heart condition, the panel suggests an LDL goal of 100, with the option to push levels even lower. However, the NCEP also notes that not everyone with diabetes needs a cholesterol-lowering drug. If a person with diabetes is young and has no other risk factors, he or she has moderate risk of heart disease and can implement lifestyle changes as long as LDL levels stay below 130 mg/dL. If they go higher, drug therapy can be used.

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Diabetes Sustenance

Diabetes Sustenance

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