By January W. Payne
May 14, 2010, at 10:01 a.m.
Diabetes raises the risk of heart disease, blindness, and stroke.
Diabetes can be a frightening diagnosis, since it is a major cause of heart disease, stroke, new cases of adult blindness, and leg and foot amputations. Each day, more than 4,000 adults are diagnosed with the disease, and about 200 people die from it, according to the Centers for Disease Control and Prevention.
Because diabetes affects roughly 24 million Americans—and can be life altering—it’s important to educate yourself about the condition and what it means for your lifestyle. The next 7 slides contain suggestions to get you started, pulled from prior U.S. News reporting.
Know fact from fiction.
There are many mistaken beliefs about diabetes. The American Diabetes Association recently surveyed more than 2,000 Americans about the most common diabetes misconceptions, such as the belief that eating too much sugar causes diabetes, or that a diabetes diagnosis means you automatically need insulin. It’s also not true that only older people get diabetes, that diabetes means your diet has to be totally different from everyone else’s, or that being overweight means you’ll end up with diabetes. It’s important to know fact from fiction, experts say, so that you can properly care for your condition and lead a healthier, longer life.
Incorporate flexibility into your diabetes diet.
Among the first things a newly diagnosed diabetic is told: eat a low-fat diet to help control cholesterol levels, and watch carbohydrate intake to keep glucose levels in check. But how do diabetics accomplish this without giving up foods they truly love? It turns out, they may not have to, experts say.
Asking people with diabetes to commit to strict diets over a long period usually doesn’t work, experts say. Those newly diagnosed with diabetes should be taught theprinciples behind their new eating style. A good starting point is to understand what carbohydrates, fat, and proteins are, and how they affect blood glucose levels. For example, a diet low in saturated and trans fats is key because it can help reduce a diabetic’s elevated odds of developing heart disease.
Be aware of the risks of diabetes medications, like Lantus and Avandia.
Recent years have brought some disturbing findings about risks that may be associated with certain diabetes medications. Some research indicates that Avandia (rosiglitazone) might cause cardiovascular problems, which has prompted some experts to demand that it be pulled from the market, although the drug is still available today. Also, in June 2009, studies published by the journalDiabetologia raised concern about a possible link between Lantus (insulin glargine) and a heightened risk of cancer.
Qualms about these drugs come from different types of research. The research on Lantus and cancer is based on observational data, which is not always reliable. The Avandia studies come from meta-analyses and clinical trials, which are considered more reliable than observational data. But none of the concerns mean that diabetics should stop taking these medicines without first talking to their doctors. Stopping a drug without a doctor’s OK can cause harm that outweighs the potential risks of the medications themselves, experts say.
Ask family members to take a self assessment.
Because we know that diabetes tends to run in families, it’s not a bad idea to ask your loved ones to assess their diabetes risk. A questionnaire published in the December issue of the Annals of Internal Medicine makes it possible to gauge your risk of diabetes from the comfort of your own home. The results can help you determine your likelihood of developing diabetes and prediabetes, and determine whether you should see a doctor for a blood glucose test right away.
Want to know your family member’s risk? Ask them to take the self assessment.
Lower your A1C levels without medication.
Diet and exercise are the best ways to lose weight and lower A1C levels, experts say. Diet in particular has the strongest natural effect on A1C levels (a measure of blood sugar over time), Matt Petersen, director of information resources for the American Diabetes Association, has told U.S. News. That’s because most people ingest more calories than can be burned off by exercise, even if physical activity is increased, according to Petersen.
The type of diet you follow doesn’t matter so much as whether it restricts your calorie intake. Aim to get 20 to 30 minutes of moderate exercise most days of the week to help maintain weight loss.
Protect your heart.
Recent research indicates that people with diabetes may not be helped by medicines that lower their blood sugar or blood pressure to normal or below-normal levels. A March study found that diabetics who had moderately high blood pressure didn’t benefit from taking extra medication to reduce blood pressure to slightly less than 120 mm Hg. In fact, they were more likely than those who kept their blood pressure in the 130s range to deal with the effects of low blood pressure, including fainting, heart arrhythmias, and abnormally high potassium levels. But previous research has shown that diabetics who have a systolic blood pressure above 140 or a diastolic (lower number) above 90 do get some benefit from taking blood pressure medication, including a lower risk of heart attacks and strokes.
The takeaway: Some people may need blood pressure and blood sugar medications, but there’s no substitute for making lifestyle changes. Losing weight, exercising more, and improving your diet will lead to better control of diabetes and lower risk of heart disease.
Know: more treatment options may be coming.
The anti-inflammatory medication salsalate was first considered as a potential diabetes treatment during the 1800s, but it never caught on. Now, the drug may be making a comeback as a type 2 diabetes treatment.
A March study of people with type 2 diabetes published in the Annals of Internal Medicine found that more people treated with salsalate saw their A1C levels decrease than did those in the placebo group. About 44 percent of those taking 3 grams per day of salsalate, 54 percent of those taking 3½ grams per day, and 60 percent of those taking 4 grams per day saw their A1C levels decrease by more than 0.5 percent, compared with 15 percent of those in the placebo group. The results of the small study, whose participants included 108 people ages 18 to 75, are considered preliminary. The medicine has a long way to go before being of potential use for diabetics. Even if it passes all the research and regulatory requirements, it could still be another five to 10 years before it gains approval as a new diabetes treatment.