Vim & Vigor - Summer 2019 - UVA - 17

"The response to vacillations in blood
sugar and insulin levels means that other
regulatory systems become active, causing consequences like high blood pressure," Yancy says. And once you develop
a second issue such as hypertension, physicians are especially concerned.
"Now you are really at risk for having
things that we worry about as cardiologists, such as heart attacks, heart failure,
stroke and kidney failure," Yancy says.
The connections between cardiovascular problems and type 2 diabetes
are, as Yancy says, "so strong and
so profound" that doctors even have
a name for what it means to have a
combination of risk factors: cardiometabolic syndrome. The Journal of
Diabetes & Metabolism has called it a
"global epidemic."
If people are having annual physicals,
doctors can help them spot what Yancy
calls "cardiometabolic risk factors,"
such as weight gain or increased blood
pressure or cholesterol. Even if the
numbers don't officially fall in the high
ranges yet, these kinds of increases can
often precede diabetes.

What You Can Do

According to Yancy, whether you have
type 2 diabetes or a diagnosis like
hypertension or high cholesterol, the
solution is the same: Start practicing
smart daily habits.
"It begins and ends with a conversation about lifestyle, both to prevent
diabetes and cardiac conditions and to
treat these issues," Yancy says.
3 Don't smoke. Smokers are 30 to
40 percent more likely to develop diabetes, and the surgeon general reports
that 1 in 4 deaths from cardiovascular
disease are caused by smoking. People
with diabetes who smoke also have
more trouble controlling blood sugar.
3 Lose weight (or don't gain it).
Obesity is a risk factor for all the diseases mentioned above, and Yancy
warns that someone's BMI (or body
mass index, a measure of weight relative

to height) may creep up slowly over
several years. It doesn't take a drastic
weight gain to be classified as medically overweight.
For example, a woman who is 5 feet,
4 inches tall would have a healthy BMI
at 145 pounds, but she'd be considered
overweight at 150. "Most of us need to
be at lower weights for medical reasons,
not cosmetic ones," Yancy says.
3 Eat less and smarter. Yancy recommends people follow a heart-healthy
eating plan. This means limiting sodium
and saturated fats, increasing foods rich
in fiber and potassium, and including
olive oil, fruit, vegetables, beans, nuts,
seeds, whole grains and lean protein.
"This can lower systolic blood pressure as much as 11 points, and it can
also help someone who is prediabetic
or diabetic," he says. Finally, limit or
avoid alcohol.
3 Prioritize exercise. Yancy recommends that all adults aim for 150 minutes
of movement each week, which could
mean 20 minutes of daily brisk walking
on weekdays and a longer workout on
Saturday or Sunday.
As a cardiologist, Yancy tries to persuade people to change their habits
before taking medication. "The same
logic applies to everyone, and what I tell
my patients is: Stick to the basics-do
more, eat less and know your numbers."
Doing so will not only help you prevent or manage chronic conditions like
diabetes and heart disease, but it will
also ensure you stay healthy and active
enough to fully enjoy life. ■

The 3 Health
Tests You Need
Each Year
All adults should have these three
key health markers checked annually
and track their results. Even gradual
increases can be risk factors for diabetes
or heart disease.
"If their blood pressure or blood sugar
is going up, a lot of people won't feel the
symptoms," says Clyde W. Yancy, MD,
deputy editor of JAMA Cardiology.
Blood pressure. This measurement,
expressed in two numbers, refers to
the force of blood as it flows through
blood vessels. Systolic blood pressure
(the first number) is how much pressure the blood exerts against artery walls
when the heart beats, while diastolic
(the second number) reflects the same
thing, but between beats. Untreated high
blood pressure can damage blood vessels and force your circulatory system to
work harder.
Hemoglobin A1C. Also called HbA1c,
this number is a measurement of your
average blood glucose over the previous
two to three months. It's an important
way to screen for prediabetes (a precursor to diabetes), and it helps people with
diabetes know how well they are controlling their blood sugar.
Lipid panel. This shows your cholesterol numbers, including total cholesterol, LDL (low-density lipoprotein, also
called "bad cholesterol"), HDL (highdensity lipoprotein, or "good cholesterol") and triglycerides, another form
of fat found in the blood that can be
caused by taking in excess calories.

APP

Diabetes Data Entry Made Easy
The mySugr app, available in the Apple App Store and Google Play, was developed by people with diabetes-and a sense of humor. A goofy monster will keep
you chuckling as you input blood glucose numbers, medications, meals and carbs.
You can sync it with the Apple Health app and Accu-Chek glucose meters.

SUMME R 2019

Vim & Vigor - Summer 2019 - UVA

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