By Cheng-Han Chen, MD, as told to Stephanie Booth
Even when your blood glucose levels are managed well, type 2 diabetes raises your risk of serious heart issues like stroke, heart attack, and heart failure.
A good relationship with your doctor is important. They can not only help you protect your health but also answer questions and address concerns.
Here, Cheng-Han Chen, MD, medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, California, shares what he’s learned from his patients who live with heart disease and type 2 diabetes — and the challenges that they’ve worked together to solve.
The Connection Between Diabetes and Heart Disease
I originally trained as an engineer and spent many years in the medical device industry. I worked on the development of many common cardiovascular devices in use today, such as drug-eluting stents [small mesh tubes that help keep arteries open] and pacemakers. This experience opened my eyes to the enormous prevalence of heart disease in our society and drove me to become a cardiologist to help alleviate the burden of this disease in people.
Diabetes greatly increases your risk of developing heart disease. This is because the excess blood sugar increases inflammation in your blood vessel walls, which then leads to increased plaque buildup. As these blockages progress, they can then lead to decreased blood flow and eventually, heart disease. Because of this, many of my patients — about 1 in 10 — have both conditions together.
Helping to Reduce the Risk to Your Heart
Living with diabetes and cardiovascular disease puts you at particular risk of suddenly developing a heart attack (acute myocardial infarction), in which one of your heart arteries closes off. People with a clogged artery frequently have symptoms of chest pain or pressure. Sometimes they describe shortness of breath with exertion, and sometimes they only notice some fatigue. These symptoms will usually go away after the clogged artery is opened.
One of the most rewarding aspects of my job is being able to help these patients by quickly getting into the clogged artery and opening it up with a stent. This usually improves your symptoms tremendously and improves your longer-term prospects as well.
Take Small Steps Toward Healthier Eating
The most challenging aspect of my job is knowing that much of the disease burden of diabetes and cardiovascular disease is not under my control or my patients' control. There are so many structural and social factors that shape the risk and burden of these conditions in our population.
For instance, many of my patients do not have easy access to healthy food. Or they’re too drawn to the convenience and specifically engineered taste of the highly processed foods that fill our grocery store shelves. My advice usually revolves around cutting back on the unhealthiest aspects of your diet. For instance, you can limit your intake of salt and sugar, foods with a lot of saturated fat, and especially, highly processed foods.
While this may be difficult, you can take smaller steps in the beginning. Some of the unhealthiest foods that we eat are meals served at restaurants. By cutting back on eating out just once or twice a week, you can greatly decrease your intake of salt and fat and also help your wallet out at the same time.
But my advice to patients regarding healthier eating often runs into the reality of a food industry that’s not particularly designed to keep us healthy.
Get Creative With Activity
I think a common frustration among my patients is not being able to get enough physical activity. I typically recommend [trying to get] at least 30 minutes of moderate-intensity physical activity on most days of the week. While any activity is better than none, ideally, it should be at a level that gets your heart rate up.
I frequently spend time brainstorming with patients on how to increase their physical activity. People often have mobility issues, either because of joint issues or obesity. Or they have limited access to exercise space, have trouble with motivation, or simply are too busy with work to devote time to exercise.
Recently, I saw a patient who wasn't getting regular exercise because of her chronic knee pain. We discussed potential ways that she could move more and hit on the fact that she had a swimming pool in her community. By spending time in the pool doing water exercises and light swimming, she was soon able to develop a regimen of physical activity that she found enjoyable.
This experience demonstrated that there are frequently solutions to the problems around us. They just take a little creativity to solve.
Find a Doctor Who’s the Right Fit
If you live with diabetes or are at risk for heart disease, it’s important to develop a good relationship with your doctors. Sometimes you may need to meet with different endocrinologists and cardiologists before you find the right "fit" in personality.
Our treatment recommendations are always evolving. Having good and open communication will help us better understand the specific problems that you’re having and come up with the best solution together.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Cheng-Han Chen, MD, board-certified interventional cardiologist; medical director, Structural Heart Program, MemorialCare Saddleback Medical Center, Laguna Hills, California.
American Heart Association: “Cardiovascular Disease and Diabetes.”
