Practical Practitioner
By: Pamela Egan, FNP-C CDE
Diabetes increases the risk of cardiovascular disease
People with diabetes are at an increased risk for cardiovascular disease (CVD). Unfortunately, many of these patients are not even aware of this danger.
Many people with diabetes are uninformed about the link between their disease and the risk of CVD. It is well recognized that a person who has had a previous heart attack is at a markedly increased risk of another heart attack. However, it is less well known that a person with diabetes who has never had a heart attack carries the same risk as someone without diabetes who has already had a heart attack. The patient with diabetes who has already suffered a heart attack is at the greatest risk of a recurrent event.
Perhaps more concerning is that diabetes experts estimate that about half of all people with diabetes remain undiagnosed. These people may be at the most risk for CVD complications.
Patients with diabetes can limit their chances of CVD problems by managing their health and diet. Control of diabetes can be achieved by working with health care providers whose recommendations will likely include significant lifestyle modifications that might be difficult to maintain and may be accompanied by complicated medical regimens. The patient and health care provider must work together to find ways to implement these recommendations on a long-term basis to reduce cardiovascular risk successfully.
The risk of CVD among patients with diabetes can be reduced by attention to other known cardiac risk factors, including smoking, high blood pressure, high cholesterol and obesity. These risk factors take on added importance in patients with diabetes. Current practice guidelines therefore recommend that blood pressure and cholesterol levels be treated in all diabetic patients as aggressively as in the person with a prior heart attack.
A healthy diet and exercise program can help to reduce the risk of developing diabetes. A healthy diet is particularly important to manage patients with existing diabetes by lowering blood pressure, cholesterol levels and weight. But if blood pressure and cholesterol levels cannot be controlled by diet and exercise alone, medications should be aggressively added to the treatment regimen.
Patients with diabetes need to be particularly aware of all CVD symptoms and should report immediately to a clinician if they are experiencing any of these signs. Symptoms of possible vascular problems include the sensation of chest tightness or pressure, shortness of breath, arm or jaw discomfort, and nausea or lightheadedness, especially with exercise.
This article was originally published July 7, 2003 in The St. Tammany News.
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