Closely Linked

How diabetes and pre-diabetes affects your heart

If you have diabetes, the truth is you are more likely to experience a heart attack, stroke or another cardiovascular health problem than any other complication of diabetes.

In fact, heart disease is the leading cause of diabetes-related deaths. Scientists are just discovering why this is.

“If you have type 2 diabetes, your chances of developing symptoms of hardening of the arteries from a build up of fatty substances that block blood flow (atherosclerosis) are extremely high—high enough that they are equal to those of someone who’s already had a heart attack,” says Anthony L. McCall, M.D., Ph.D., co-director of UVA’s Diabetes Cardiovascular Clinic.

Even blood sugar levels in the “pre-diabetes” range — levels higher than normal but not high enough to be called diabetes — put you at an increased risk of atherosclerosis, McCall notes.

Comprehensive Attack   

“The word ‘syndrome’ comes from a Greek word meaning ‘running together.’

The major risk factors for cardiovascular disease and diabetes run together a long way,” McCall explains.

Both diseases may have their roots in the teens or younger and can be both genetic and lifestyle related. Either disease may precede the other.

The only way to truly break the cycle of disease is to launch a comprehensive attack on all of the risk factors, McCall stresses.

“You can’t just treat the blood pressure or the glucose or the sedentary lifestyle or bad diet, or high cholesterol,” says McCall. “You’ve got to treat them all. Through teamwork, we can help this happen.”

Treatment at UVA

UVA’s innovative Diabetes Cardiovascular Clinic is designed specifically to offer diabetes patients the support, guidance and specialized treatment they need to control the risk factors that comprise metabolic syndrome.

“Here at the clinic, endocrinologists (diabetes doctors) and cardiologists (heart doctors) practice side by side with dietitians, exercise physiologists, cardiac rehab nurses, diabetes educators, and a pharmacist,” says McCall, who co-directs the clinic along with Angela Taylor, M.D.

Patients typically are referred to the clinic by their primary care doctor.

From one visit to the next:

• An exercise physiologist may go over barriers to physical activities.
• A cardiac rehabilitation nurse may help set reasonable goals for physical activity.
• A registered dietitian may meet with the patient, as well as the person from the household who does the food preparing and shopping, to suggest effective changes that can help reduce blood sugar or blood pressure levels.
• A doctor will meet with the patient at most visits.

All team members work closely together to ensure that each patient has the right self-care plan in place and that their therapy is monitored and adjusted according to the patient’s primary care doctor’s recommendations.

One satisfied patient of the clinic is Barbara Blair.

Blair, who lives 30 minutes outside of Charlottesville, has been visiting the clinic team ever since she learned she had diabetes.

“I can't emphasize enough,” she says, “how fascinating it is to watch the team at work. One is specializing in diet and one on exercise. I’ll go see the diabetes doctor with the team and go back and see the heart specialist with the same team. Everybody knows everything. And of course, that benefits the patient.”

Enlist UVA’s Team
If you have diabetes and would like help improving your heart health, talk to your doctor about a referral to the UVA Health System’s Diabetes Cardiovascular Clinic.

Do You Have Metabolic Syndrome?

Some 50 million Americans suffer from metabolic syndrome, a cluster of health problems that are major risk factors for heart disease, stroke and diabetes.

A person has metabolic syndrome, if they have three or more of the following conditions:

• Obesity, especially around the waist (having an “apple-shaped” body)
• High blood pressure
• High cholesterol levels
• High triglycerides (a type of blood fat)
• Resistance to insulin, a hormone that helps regulate blood sugar

“These conditions are all interrelated, and they exacerbate one another,” says Kim E. Innes, Ph.D., of the UVA Health System.

Meaning, if you have one, you’re likely to have another, and the more of these factors you have, the higher your risk for major health problems.

Certain lifestyle changes can help reduce these risks: regular physical activity, weight loss and smoking cessation.