In addition to the ABCs of diabetes care, there are many steps you can take to stay healthy.
The great thing about a heart-healthy diet is that it's good for everyone, including people with diabetes.
- In general, your diet should be nutritionally balanced, high in fiber, low in fat (especially saturated fat) and moderate-to-low in salt.
- Load up with vegetables.
- Choose lean meats, chicken and fish - and prepare them by baking or broiling.
- Choose low-fat or fat-free dairy products.
- Avoid high-sodium processed foods, and limit how much salt you add to food.
- Enjoy some fresh fruit every day.
- As for how much you should eat of starchy foods like bread, pasta, potatoes and rice, follow the advice of your doctor and dietitian.
- Finally, watch the calories. Too much of any food can cause you to gain weight, and that will make it hard to control your diabetes.
If you choose to drink alcohol, limit it to one drink for women and two drinks for men per day. (One drink is a 12-ounce beer, a 4-ounce glass of wine, or 1.5 ounces of distilled alcohol.) Keep in mind that alcohol has a lot of calories. In addition, it tends to raise blood levels of triglycerides.
Increasing your physical activity is one of the best ways to reduce the risk for heart attack and stroke. Exercise can help you to lose weight, prevent or delay the onset of Type 2 diabetes, reduce blood pressure and relieve stress. It also helps make the body's cells more responsive to insulin. The goal for most people is at least 30 to 60 minutes of exercise on most days of the week.
Cigarette smoke is not only bad for the lungs, it's toxic to the blood vessels and increases the risk of heart attack and stroke People with diabetes are especially vulnerable to the bad effects of smoking. Quitting smoking is difficult, but it is well worth the effort. Talk with your doctor about getting help with smoking cessation.
Obesity is not only a major risk factor for cardiovascular disease, it plays a central role in insulin resistance and has been linked to high blood pressure. If you are overweight, losing those extra pounds will reduce your risk of heart attack and stroke, improve your sensitivity to insulin and help you to control your blood sugar levels.
People with diabetes know how important it is to take insulin or oral anti-diabetic medications. It's just as essential to take medications to prevent or treat cardiovascular disease, if your doctor has prescribed them. Depending on your individual health needs, you may need to take the following:
- Blood pressure medication. Anyone who has both diabetes and high blood pressure should be treated with medication to bring the blood pressure down to 130/80 mmHg or less. Many doctors will prescribe a type of medication known as an ACE inhibitor (or a related medication known as an ARB). These medications not only control the blood pressure, they also appear to protect the heart and kidneys, so they are especially helpful in people with diabetes. If you need more than one medication to keep your blood pressure under control, your doctor may also prescribe a thiazide diuretic, a beta blocker or a calcium-channel blocker.
- Cholesterol-lowering medication. If your LDL cholesterol is high, your doctor may prescribe a statin. If your triglycerides are high, it may be necessary to take niacin or a fibrate medication.
- Aspirin. Low-dose aspirin (75 to 162 mg daily) is recommended for people who know they have coronary artery disease (such as if you have had a heart attack in the past). But for those who want to prevent cardiovascular disease from developing, aspirin's role is less clear. The American Diabetes Association, American Heart Association and American College of Cardiology released joint recommendations that address this question. The recommendations reflect a balance between aspirin's moderate benefit in reducing the risk for cardiovascular disease and its potential to increase the risk of bleeding from the stomach and gastrointestinal tract. Current recommendations for the prevention of vascular disease state:
- Low-dose aspirin is reasonable for adults with diabetes who are not at increased risk for gastrointestinal bleeding but are at increased risk for cardiovascular disease (older than age 50 for men and age 60 for women PLUS at least one major heart disease risk factor).
- Low-dose aspirin might be considered for adults with diabetes who are at intermediate risk for cardiovascular disease (younger patients with one or more risk factors, or older patients with no risk factors).
- Aspirin is not recommended for adults with diabetes at low risk for cardiovascular disease (men under age 50 and women under age 60 with no major risk factors).