Title: Diabetes and Cardiovascular Disease
1Diabetes and Cardiovascular Disease
- Jeanne Jacoby, ARNP
- Dartmouth Hitchcock Medical Center
- Section of Endocrinology
- Get Heart Smart!
- February 7, 2009
2What is Diabetes?
- Diabetes is a disease in which the body does not
produce or properly use insulin. - The cause of diabetes continues to be a
mysterylikely multi-factorial - Genetics
- And
- Environmental factors such as obesity and lack of
exercise appear to play roles.
From http// www.diabetes.org
3Major Types of Diabetes
- Type 1 diabetes
- Results from the body's failure to produce
insulin, the hormone that "unlocks" the cells of
the body, allowing glucose to enter and fuel
them. - It is estimated that 5-10 of Americans who are
diagnosed with diabetes have type 1 diabetes. - Type 2 diabetes
- Results from insulin resistance (a condition in
which the body fails to properly use insulin),
combined with relative insulin deficiency. - Most Americans who are diagnosed with diabetes
have type 2 diabetes.
From http// www.diabetes.org
4Other Glucose intolerance
- Gestational diabetes
- Diabetes during pregnancy
- Immediately after pregnancy, 5 to 10 of women
with gestational diabetes are found to have
diabetes, usually, type 2. - Pre-diabetes
- Pre-diabetes is a condition that occurs when a
person's blood glucose levels are higher than
normal but not high enough for a diagnosis of
type 2 diabetes. - There are 57 million Americans who have
pre-diabetes, in addition to the 23.6 million
with diabetes.
From http// www.diabetes.org
5Diagnosing Diabetes
- Fasting Blood Glucose (FBG)
- Blood Glucose Level is measured after a fast
- Oral Glucose Tolerance Test (OGTT)
- Blood glucose level is measured fasting and two
hours after drinking a glucose-rich beverage
From http// www.diabetes.org
6Prevalence of Diabetes
- 23.6 million children and adults in the United
States (7.8 of the population) have diabetes - 17.9 million have been diagnosed with diabetes
- 5.7 million people are unaware that they have the
disease - Another 57 million people have pre-diabetes
From http// www.diabetes.org
7Whats the Link?
- Cardiovascular Disease (CVD)
- And
- Diabetes
8(No Transcript)
9Meet Jack
- 40 year old man presents to his PCP for a
physical after 5 years away - No prior medical history
- Overweight
- He does not exercisetoo busy at work
- New Diagnoses
- Type II diabetes
- High Blood Pressure
- High Cholesterol
- Family History of Heart Disease and Diabetes
10Diabetes-CVD Facts
- More than 65 of all deaths in people with
diabetes are caused by cardiovascular disease. -
- Heart attacks occur at an earlier age in people
with diabetes and often result in premature
death.
11Diabetes-CVD Facts
- Up to 60 of adults with diabetes have high blood
pressure. - Nearly all adults with diabetes have one or more
cholesterol problems, such as - high triglycerides
- low HDL (good) cholesterol
- high LDL (bad) cholesterol
12The Good News
- By managing the ABCs of diabetes, people with
diabetes can reduce their risk for heart disease
and stroke. - A stands for A1C
- B stands for Blood pressure
- C stands for Cholesterol
- PLUS More Bs
- BMI
- Blood Sugars
13Jacks ABCs
- A1c - 9.1
- Blood Pressure 150/90
- Cholesterol
- LDL 120
- HDL 30
- Total Cholestrol 230
- Body Mass Index (BMI) 30
- Height 61
- Weight 225 lbs
- Fasting Blood Sugar (on diagnosis) 200
14Ask About Your A1C
- A1C measures average blood glucose over the last
three months. - Get your A1C checked at least twice a year.
7
A1C Goal less than
15Getting Jack to GoalHemoglobin A1c
- Eat the right foods.
- Get daily physical activity.
- Test blood glucose regularly.
- Take medications as prescribed.
9.1 ? 7.0
16Beware of Your Blood Pressure
- High blood pressure raises your risk for heart
attack, stroke, eye problems and kidney disease. - Get your blood pressure checked at every visit.
- Target BP less than
130/80
17Getting Jack to GoalBlood Pressure
- Eat more fruits and vegetables.
- Reduce the amount of salt in diet.
- Lose weight.
- Lower alcohol intake.
- Quit smoking.
- Take blood pressure pills.
150/90 ? 130/80
18Check Your Cholesterol
- Several kinds of blood fats
- LDL (bad) cholesterol - can narrow or block
blood vessels - HDL (good) cholesterol - helps remove
cholesterol deposits - Triglycerides - can raise your risk for heart
attacks/stroke
19ADA Goals for Cholesterol
100
- Target LDL less than
- Target HDL above (men) above (women)
- Target triglycerides less than
40
50
150
20Getting Jack to GoalCholesterol
- Eat less saturated fat
- Foods high in saturated fat fatty meats,
high-fat dairy products, tropical oils - Eat foods high in fiber
- Examples oatmeal, beans, peas, citrus fruits
- Take cholesterol-lowering medication
- Exercise regularly
LDL 120 ? 95
21Body Mass Index
- Being overweight or obese is a leading risk
factor for type 2 diabetes. - A healthy weight is measured by your body mass
index (BMI).
25
BMI Goal less than
22Getting Jack to GoalBody Mass Index
- Diet
- Choose foods low in Saturated Fat
- Eat Moderate Amounts of Carbohydrates
- Exercise
- Be more active throughout the day.
- Examples work in the garden, play with the kids,
take the stairs - Walk - work up to at least 30 minutes of walking
on most days
30 ? 25
23Other Strategies
- Get help to quit smoking.
- Talk to your health care provider about taking
aspirin and other medications to reduce your risk
for heart disease and stroke.
24Check out your profile
- https//www.diabetes.org/diabetesphd
25Key Points Review
- People with diabetes are at a very high risk for
heart attack and stroke. - More than 2 out of 3 of people with diabetes die
of heart disease or stroke. - Diabetes is more than managing blood glucose.
Its managing blood glucose and blood pressure
and cholesterol. - Know the ABCs of Diabetes.
- A1c, Blood Pressure, Cholesterol
- More treatments are available than ever before.
Talk to your healthcare provider and learn what
you can do to manage your ABCs.
26General Tips
- Take steps to lower your risk of D-CVD
complications - A1C lt 7.
- Blood pressure lt 130/80.
- Cholesterol (LDL) lt 100.
- Cholesterol (HDL) gt 40 (men) and gt 50 (women).
- Triglycerides lt 150.
- Get help to quit smoking.
- Be active.
- Make healthy food choices.
- Talk to your doctor about medication.
27For More Information
- Call 1-800-DIABETES
- Visit www.diabetes.org/MakeTheLink
- Email MakeTheLink_at_diabetes.org
- Contact me
- jeanne.m.jacoby_at_hitchcock.org
28One Away
As seen on The Price is Right
29A New Jeep!
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30Hemoglobin A1c
Target!
8
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7
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31Blood Pressure
Target!
2
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7
9
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32LDL Cholesterol
Target!
2
9
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33Triglycerides
Target!
2
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34BMI
Target!
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