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Diabetes Attack
Question: Why do diabetics have an increased risk of cardiovascular disease?
Answer: The increased risk comes from several factors. Firstly, diabetes occurs for the same reasons and in the same people as other risk factors for the heart such as obesity and high blood pressure. Over-eating and lack of exercise are common to these, so the risk multiplies. More importantly, it appears that diabetes is associated with an increase in inflammation markers in the blood and a decrease of the 'good' high density cholesterol, which together seem to damage the linings of blood vessels and begin a process of arterial narrowing.
Question: Is it true that diabetics have fewer symptoms and there for greater chances of a silent heart attack?
Answer: Long-standing diabetics do have fewer symptoms. The most likely reason is that diabetics can have damage to nerve endings (neuropathy), and some of the pain-sensing nerves for the heart may not function properly.Question: Apart from a heart attack, what other types of heart problems can diabetics have?
Answer: A heart attack is the end result of a long process of narrowing of the arteries going to the heart. All other blood vessels can also be affected, including those to the legs and brain, causing strokes and problems in the feet. Changes in the vascular and nervous systems can affect the control of heart rates and rhythm and blood pressure.
Diabetic patients with poorly functioning nerves to the heart can have a fast resting pulse (tachycardia) and a loss of the beat to beat variation in heart rate with deep breathing, a sign of health.
They can also have a drop in blood pressure if they stand up suddenly and sluggish heart rate and blood pressure changes when they exercise.
Question: What can diabetics do to stay heart-healthy?
Answer: It is important to understand that most adult-onset diabetes is preventable and perhaps even curable. The key is to reduce excess eating and to increase activity and exercise. This needs to start at the earliest possible age and become a lifelong habit. With the adoption of a modern lifestyle of sitting at a desk, watching television, traveling in a car, one has to find the time to walk. Getting plenty of sleep (7-8 hours) also helps curb the appetite. Stress reduction should play an important role. I believe peace of mind promotes good health of all kinds.
Question: For how long do diabetics need to exercise?
Answer: Going for a 15-minute walk about an hour after every meal will keep sugar levels (and more importantly insulin levels) lower. A longer walk, several times a week, will reduce the build up of sugar stores. Additionally, regular strength training, whether through lifting weights in a gym or practicing Hatha yoga increases muscle mass and improves sugar control. Reduction of the total calories consumed is important, as well as the mix of foods.
Question: What sort of foods should diabetics take?
Answer: They should eat lots of vegetables cooked in healthy oils and reduce simple starches. Avoid potatoes, noodles, breads and rice. I have one or two chapattis at the most and eat rice as a side dish like pickle! When I do this I find I can eat large quantities of pulses and vegetables with double toned yogurt and not leave the table hungry. Vegetables like bitter gourd and ivy gourd are particularly helpful for diabetics.
Question: What should they avoid?
Answer: Whole fruits are much better than fruit juices, since the sugars are tied up in the fiber of the pulp and digested slowly. Vegetable oils like groundnut, mustard and safflower oil should be staples. Animal and dairy fats, shortening and whole milk cheese should be avoided. Ghee in moderation is acceptable. Obviously, sweets need to be eaten only occasionally. I try to go for a brisk walk an hour after I indulge in a dessert to keep the sugar and insulin levels low.
There are many supplements, spices and Ayurvedic compounds which have been shown to have some benefit, although none is a cure-all. Turmeric, cinnamon, and fenugreek have good evidence.
Spices
Additionally, two supplements important in the activity inside cells, L-carnintine and alpha-lipoic acid, have been shown to help with sugar metabolism. Finally, chocolate has compounds which may be very good for diabetics. Unfortunately, the sugar in most, cancels the benefit! I tend to eat very dark chocolate as a treat, just before or after exercise.
Which Came First?
Cross-sectional studies have found a link between having diabetes and being depressed. But it is not clear if depression leads to diabetes or if diabetes leads to depression.Lifestyle changes
Researchers found that people with diabetes had a 30% higher risk of developing depressive symptoms than people who did not have diabetes and a 91% higher risk of recurrent depressed mood. The increased risk of depression was mostly seen among people with poorly controlled blood glucose levels.
Organic pollutants trapped in fat is the culprit
Evidence is growing that persistent organic pollutants (POPs), such as organ chlorine pesticides and PCB s, may play a role in the development of type 2 diabetes. POPs accumulate in fatty tissue. A study reported in the March 2007 issue of Diabetes Care found that POPs might interact with obesity to increase the risk of insulin resistance, a precursor of type 2 diabetes.
Organic pollutants
Obese people who had POPs in their blood were more likely to develop insulin
resistance than thin people who had POPs in their blood. However, obese people who did not have POPs in their blood did not have an increased risk of developing insulin resistance. It could be that the development of type 2 diabetes is linked to the POPs stored in fat rather than obesity itself.Lifestyle changes as effective as drugs for checking diabetes
A meta-analysis of 17 trials with a total of 8,084 participants found that lifestyle interventions were as effective as drug therapy for preventing or delaying the development of type 2 diabetes in people with impaired glucose tolerance. Compared to standard advice, lifestyle interventions (nutrition, weight-loss, exercise) were associated with a 49% decrease in risk, while oral diabetes drugs as a whole reduced the risk by 30%, and drugs reduced the risk by 56% compared to placebos.