Prevent Diabetes Problems: Keep Your Heart and Blood Vessels Healthy

What are diabetes problems?

Too much glucose (sugar) in the blood for a long time can cause diabetes problems. This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes, the leading causes of death for people with diabetes. You can do a lot to prevent or slow down diabetes problems.

This booklet is about heart and blood vessel problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.

What should I do each day to stay healthy with diabetes?

What do my heart and blood vessels do?

Your heart and blood vessels make up your circulatory (SIR-kyoo-la-TOR-ee) system. Your heart is a muscle that pumps blood through your body. Your heart pumps blood carrying oxygen to large blood vessels, called arteries (AR-ter-eez), and small blood vessels, called capillaries (KAP-ih-lair-eez). Other blood vessels, called veins, carry blood back to the heart.

What can I do to prevent heart disease and stroke?

• Keep your blood glucose under control. You can see if it is under control by having an A1C test at least twice a year. The A1C test tells you your average blood glucose for the past 2 to 3 months. The target for most people is below 7.
  
  
• Keep your blood pressure under control. Have it checked at every doctor visit. The target for most people is below 130/80.
  
  
• Keep your cholesterol under control. Have it checked at least once a year. The targets for most people are
  
  
  • LDL (bad) cholesterol: below 100
    
    
  • HDL (good) cholesterol: above 40 in men and above 50 in women
    
    
  • triglycerides (another type of fat in the blood): below 150
  
  
  
• Make physical activity a part of your daily routine. Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you. Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the lot.
  
  
• Make sure that the foods you eat are "heart-healthy." Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits, and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods.
  
  
• Lose weight if you need to. If you are overweight, try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.
  
  
• If you smoke, quit. Your doctor can tell you about ways to help you quit smoking.
  
  
• Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
  
  
• Take your medicines as directed.

How do my blood vessels get clogged?

Several things, including having diabetes, can make your blood cholesterol level too high. Cholesterol is a substance that is made by the body and used for many important functions. It is also found in some food derived from animals. When cholesterol is too high, the insides of large blood vessels become narrowed or clogged. This problem is called atherosclerosis (ATH-uh-row-skluh-RO-sis).

Narrowed and clogged blood vessels make it harder for enough blood to get to all parts of your body. This can cause problems.

What can happen when blood vessels are clogged?

When blood vessels become narrowed and clogged, you can have serious health problems:

• Chest pain, also called angina (an-JY-nuh). When you have angina, you feel pain in your chest, arms, shoulders, or back. You may feel the pain more when your heart beats faster, such as when you exercise. The pain may go away when you rest. You also may feel very weak and sweaty. If you do not get treatment, chest pain may happen more often. If diabetes has damaged the heart nerves, you may not feel the chest pain.
  
  
• Heart attack. A heart attack happens when a blood vessel in or near the heart becomes blocked. Not enough blood can get to that part of the heart muscle. That area of the heart muscle stops working, so the heart is weaker. During a heart attack, you may have chest pain along with nausea, indigestion, extreme weakness, and sweating.
  
  
• Stroke. A stroke can happen when the blood supply to the brain is blocked. Then the brain can be damaged.

What are the warning signs of a heart attack?

You may have one or more of the following warning signs:

• chest pain or discomfort
• pain or discomfort in your arms, back, jaw, or neck
• indigestion or stomach pain
• shortness of breath
• sweating
• nausea
• light-headedness

Or, you may have no warning signs at all. Or they may come and go. If you have any of these warning signs, call the emergency services right away.

How do narrowed blood vessels cause high blood pressure?

Narrowed blood vessels leave a smaller opening for blood to flow through. It is like turning on a garden hose and holding your thumb over the opening. The smaller opening makes the water shoot out with more pressure. In the same way, narrowed blood vessels lead to high blood pressure. Other factors, such as kidney problems and being overweight, also can lead to high blood pressure.

Many people with diabetes also have high blood pressure. If you have heart, eye, or kidney problems from diabetes, high blood pressure can make them worse.

You will see your blood pressure written with two numbers separated by a slash. For example, your reading might be 120/70, said as “120 over 70.” For people with diabetes, the target is to keep the first number below 130 and the second number below 80.

If you have high blood pressure, ask your doctor how to lower it. Your doctor may ask you to take blood pressure medicine every day. Some types of blood pressure medicine can also help keep your kidneys healthy.

You may also be able to control your blood pressure by

• eating more fruits and vegetables
  
  
• eating less salt and high-sodium foods
  
  
• losing weight if you need to
  
  
• being physically active
  
  
• not smoking
  
  
• limiting alcoholic drinks

What are the warning signs of a stroke?

A stroke happens when part of your brain is not getting enough blood and stops working. Depending on the part of the brain that is damaged, a stroke can cause

• sudden weakness or numbness of your face, arm, or leg on one side of your body
  
  
• sudden confusion, trouble talking, or trouble understanding
  
  
• sudden dizziness, loss of balance, or trouble walking
  
  
• sudden trouble seeing in one or both eyes or sudden double vision
  
  
• sudden severe headache
  

Sometimes, one or more of these warning signs may happen and then disappear. You might be having a "mini-stroke," also called a TIA (transient ischaemic [TRAN-see-unt is-KEE-mik] attack). If you have any of these warning signs, call 999 (911 in USA, 112 in Europe) right away.

How can clogged blood vessels hurt my legs and feet?

Peripheral (puh-RIF-uh-rul) arterial (ar-TEER-ree-ul) disease, also called PAD, can happen when the openings in your blood vessels become narrow and your legs and feet don’t get enough blood. You may feel pain in your legs when you walk or exercise. Some people also have numbness or tingling in their feet or legs or have sores that heal slowly.

What can I do to prevent or control peripheral arterial disease?

• Don't smoke.
• Keep blood glucose and blood pressure under control.
• Keep blood fats close to normal.
• Exercise.
• Ask your doctor if you should take aspirin every day.

You also may need surgery to treat this problem.