Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

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Taking Diabetes to Heart

by Laura Hieronymus, MSEd, APRN, BC-ADM, CDE, and Kristina Humphries, MD

Healthy weight. The goals you set with your diabetes care team for staying active and eating healthfully should help you to achieve and maintain a healthy weight. If you need to lose weight, a sensible, gradual weight loss plan is most likely to result in permanent weight loss. Increasing your physical activity while consuming fewer calories will help to make sure the weight you are losing is fat and not muscle.

Stopping smoking. If you smoke, quitting is highly recommended because of the detrimental effects smoking has on the blood vessels and heart. That is not to say it is easy. The first step is deciding that you are willing to quit, then working with your diabetes care team to decide on a plan that will work for you.

If lifestyle changes alone don’t bring your blood glucose, blood pressure, and blood cholesterol levels into target range, drug therapy may be necessary. Some people are reluctant to take drugs, particularly if they are experiencing no symptoms or don’t feel bad on a day-to-day basis. But while high blood glucose, high blood pressure, and cholesterol disorders may cause no or few symptoms in the early stages, over time they can do real damage to your internal organs, which will cause symptoms, so it is important to treat them early.

Regularly monitoring your A1C level, blood pressure, and blood lipids will provide you and your diabetes care team with the information needed to make decisions about your need for drug therapy. Remember, medication is not the enemy if it helps keep your “ABCs” in order.

Aspirin therapy is recommended in people with diabetes as a standard practice of care. It has been shown to reduce the risk of heart attack by 30% and the risk of stroke by 20%. However, aspirin therapy is not for everyone, so you should consult your physician before you start to take aspirin regularly. Your physician will take into consideration your age, your heart disease risk factors, other drugs you might be taking, and your heart health history in making a recommendation regarding aspirin therapy.

Symptoms of heart disease
Angina, or pain that occurs when a blood vessel to the heart is narrowed and blood flow is reduced, is a common sign of heart disease. The pain can vary in severity from one episode to the next and can include chest discomfort or pain that radiates to your shoulders, arms, jaw, or back, especially during exercise. The pain may go away when you rest or take a medicine that your physician prescribes for the angina. Angina does not typically cause permanent damage to the heart muscle, but it is a symptom of diminished blood flow to the heart and a warning of an increased risk of having a heart attack.

When a blood vessel that flows to the heart becomes blocked and blood flow to the heart is inhibited, a heart attack occurs. If not enough blood reaches a part of the heart muscle, permanent damage will result.

Men and women tend to have somewhat different symptoms when having a heart attack. Common symptoms of a heart attack in men include the following:

  • Chest pain, pressure, or discomfort
  • Pain or discomfort in the arms, back, jaw, neck, or stomach
  • Shortness of breath
  • Sweating
  • Nausea and sometimes vomiting
  • Dizziness or a feeling of light-headedness

Common symptoms of a heart attack in women include these:

  • Unusual fatigue
  • Sleep disturbances
  • Shortness of breath
  • Diffuse discomfort
  • Depression

Regardless of sex, not everyone who has a heart attack has all the symptoms. In fact, some people, particularly those with diabetes, may have very subtle symptoms or none at all. This is usually because of nerve damage caused by diabetes, which may result in lack of pain during a heart attack.

If you believe you are having a heart attack, don’t delay: get emergency help immediately. Keep in mind that treatment is most effective if given within an hour of a heart attack and can prevent damage to the heart that may be permanent.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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