Home / Dr. Steven reisman, a new york city cardiologist, discusses the relationship between diabetes type 2 and heart disease
Type 2 diabetes is also known as adult-onset diabetes and is a chronic condition that affects the way your body metabolizes sugar or glucose. With type 2 diabetes one’s body is resistant to the effects of insulin or the body does not produce enough insulin to maintain a normal glucose level. Type 2 diabetes symptoms may develop slowly. Some of the symptoms include an increase in thirst, frequent urination, increased hunger, weight loss, fatigue, blurry vision, and slow healing sores. Importantly, this condition may be asymptomatic.
The risk factors for type 2 diabetes include being overweight which is a primary risk factor, inactivity, family history, and a condition known as pre-diabetes in which the blood sugar level is higher than normal but not high enough to be classified as type 2 diabetes. The most important complications of type 2 diabetes include an increase in risk for various cardiovascular disease entities such as coronary artery disease, heart attack, stroke, and narrowing of the arteries along with high blood pressure.
Type 2 diabetes can be diagnosed by a simple blood test. There are two commonly done tests: one is called the A1C test and the other one is a fasting blood sugar test. The American Diabetes Association recommends routine screening for type 2 diabetes after age 45 especially if one is overweight. Screening is also recommended for those under 45 who are overweight and if there is other heart disease or diabetes risk factors such as a family history of type 2 diabetes or an elevated blood pressure.
In a recent article, HealthDay (3/2/11, Gordon) describes the findings of the ACCORD Study. This study evaluated “intensive” glucose therapy compared to “standard” therapy in patients with type 2 diabetes and heart disease. This study found that intensive blood sugar control in a very aggressive manner does not benefit people with type 2 diabetes and heart disease and, in fact, may harm them. This study found that very aggressive attempts to control A1C may result in a decrease in the rate of heart attack but an increase in mortality. This study was published in the New English Journal of Medicine on March 3, 2011 and involved a large group of patients. One finding in this study appears to be that it is important to decrease blood glucose levels to the recommendation of below 7% A1C but possibly not below 6% A1C.
Initial treatment for type 2 diabetes includes blood glucose monitoring along with healthy eating and regular exercise. Healthy eating should emphasize plenty of fruits, vegetables, and whole grains. In addition, counting carbohydrates is important and this can be done with the help of a dietician. Aerobic exercise is important and one should aim for 30 minutes of vigorous aerobic exercise most days of the week. In addition, if one is overweight, losing excess pounds is part of the treatment regimen in type 2 diabetes. In some instances, diabetes medication may be necessary if this initial treatment program does not work.
Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, advocates prevention of type 2 diabetes with emphasis on eating healthy foods, increasing physical activity and losing excess pounds. This can be done after an initial consultation to evaluate the individual’s blood sugar level and can also be done in conjunction with a registered dietician.