Prevent diabetes problems

Keep your heart andblood vessels healthyKeep your heart andblood vessels healthy

NATIONAL INSTITUTES OF HEALTHNational Diabetes Information Clearinghouse

Prevent diabetes problems:Keep your heart andblood vessels healthy

NATIONAL INSTITUTES OF HEALTHNational Diabetes Information Clearinghouse

ContentsWhat are diabetes problems?.................................. 3

What should I do each day to stay healthywith diabetes? ........................................................... 4

What do my heart and blood vessels do? ............... 5

What damages my heart and blood vessels? .......... 6

What can I do to prevent heart and bloodvessel problems?....................................................... 7

How do my blood vessels get clogged?................... 9

What heart problems can unhealthyblood vessels cause? ............................................... 10

How does heart disease causehigh blood pressure? .............................................. 11

What are the warning signs of a stroke? .............. 13

How can clogged blood vesselshurt my legs and feet? ............................................ 14

What can I do to prevent or controlperipheral vascular disease? .................................. 14

Which medical tests will help me keep trackof any heart or blood vessel problems? ................ 15

For more information ............................................ 16

More in the series................................................... 18

Acknowledgments .................................................. 19

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What are diabetes problems?Too much sugar in the blood for a long timecauses diabetes problems. This high blood sugarcan damage many parts of the body, such asthe heart, blood vessels, and kidneys. Diabetesproblems can be scary, but there is a lot you cando to prevent them or slow them down.

This booklet is about heart and blood vesselproblems caused by diabetes. You will learn thethings you can do each day and during the yearto stay healthy and prevent diabetes problems.

High blood sugar cancause heart and bloodvessel problems.

Bloodvessels Heart

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What should I do each day to stayhealthy with diabetes?

Follow the healthy eating plan thatyou and your doctor or dietitian haveworked out. Eat your meals and snacksat around the same times each day.

Be active a total of 30 minutes mostdays. Ask your doctor what activitiesare best for you.

Take your diabetes medicine at thesame times each day.

Check your blood sugar every day.Each time you check your blood sugar,write the number in your record book.Call your doctor if your numbers aretoo high or too low for 2 to 3 days.

Check your feet every day for cuts,blisters, sores, swelling, redness, orsore toenails.

Brush and floss your teeth and gumsevery day.

Don’t smoke.

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What do my heart andblood vessels do?Your heart and blood vesselsmake up your circulatory(SIR-kyoo-la-TOR-ee)system. Your heart is abig muscle that pumpsblood through yourbody. Your heartpumps blood carryingoxygen to large bloodvessels, called arteries(AR-ter-eez), andsmall blood vessels,called capillaries(KAP-ih-lair-eez).Other blood vessels,called veins, carry bloodback to the heart.

Heart

Artery

Vein

Capillary

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What damages my heart andblood vessels?

• Having high blood sugar.

• Having high blood pressure.

• Smoking cigarettes.

• Having high blood cholesterol(kuh-LES-ter-all) and otherabnormal blood fats.

• Eating foods full of saturatedfat and cholesterol.

• Being overweight.

• Not being active.

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Follow a healthy eating plan.

What can I do to prevent heart andblood vessel problems?

• Keep your blood sugar and blood pressureas close to normal as you can.

• Keep blood cholesterol and other bloodfats as close to normal as you can.

• Take your diabetes medicines at the sametimes each day.

• Take your heart pills and blood pressurepills as your doctor tells you.

• Ask your doctor if you should take anaspirin each day to help protect your heart.

• Follow the healthy eating plan you workout with your doctor or dietitian.

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• Do not smoke.

• Tell your doctor right away if you thinkyou have any signs of heart or blood vesselproblems. Symptoms of heart and bloodvessel problems can be shortness of breath;dizziness; pain in the chest, arms, shoulder,or back; sudden loss of sight; trouble talking;or numbness or weaknessin one arm or one leg.You also may feel verytired and have swollenankles or feet. See page11 for the warning signsof stroke.

• Be active a totalof 30 minutes mostdays. Use stairs;park farther fromthe shoppingcenter. Walk,swim, do housework,or garden. Checkwith your doctor toknow what activitiesare best for you.

• Get to a healthyweight.

Choose an activity you like andstay active.

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Healthy Blood Vessel

Clogged and Narrowed Blood Vessel

How do my blood vesselsget clogged?Several things, including having diabetes, can increaseyour blood cholesterol too much. Cholesterol is asubstance that is made by the body and used for manyimportant functions. It is also found in some animalfoods we eat. When cholesterol is too high, theinsides of large blood vessels become clogged andnarrowed. This problem is called atherosclerosis(ATH-uh-row-skluh-RO-sis).

Clogged and narrowed blood vessels make it harderfor enough healthy blood to get to all parts of yourbody. This can cause one or more problems.

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What heart problems can unhealthyblood vessels cause?When arteries become clogged and narrowed, youmay have one or more heart problems:

• Chest pain, also called angina (an-JY-nuh).When you have angina, you feel pain in yourchest, arms, shoulders, or back. You may feelthe pain more when your heart works faster,such as when you exercise. The pain may goaway when you rest. You also may feel veryweak and sweaty. If you do not get it treated,chest pain may happen more often. If diabeteshas damaged the heart nerves, you may notfeel the chest pain.

• Heart attack. A heart attack happens whena blood vessel in or near the heart becomesblocked. Not enough blood can get to thatpart of the heart muscle. That area of theheart muscle stops working, so the heart isweaker. During a heart attack, you may havechest pain along with nausea, indigestion,extreme weakness, and sweating.

• Cardiomyopathy (KAR-dee-oh-my-OP-uh-thee). Cardiomyopathy happens whennarrowed blood vessels let less blood flowthrough the heart. This damage makes theheart muscle weak.

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How does heart diseasecause high blood pressure?Clogged and narrowed blood vessels leave a smalleropening for blood to flow through. It is like turningon a garden hose and holding your thumb over theopening. The smaller opening makes the watershoot out with more pressure. In the same way,narrowed blood vessels lead to high blood pressure.Other factors, such as kidney problems and beingoverweight, also can lead to high blood pressure.

Diabetes and high blood pressure often go hand-in-hand. If you have heart, eye, or kidney problemsfrom diabetes, high blood pressure can make themworse.

High Pressure Low Pressure

A smaller opening makes the water pressure higher.In the same way, clogged blood vessels lead to highblood pressure.

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To lower blood pressure, get to ahealthy weight.

You will see your blood pressure written withtwo numbers separated by a slash. For example:120/70. Keep your first number below 130 andyour second number below 85.

If you have high blood pressure, ask your doctorhow to lower it. Your doctor may ask you to takean ACE inhibitor. This type of blood pressuremedicine is best for people with diabetes whohave kidney problems because it helps keep thekidneys healthy.

To lower your blood pressure, your doctor mayalso ask you to lose weight; eat more fruits andvegetables; eat less salt and high-sodium foodssuch as canned soups, luncheon meats, saltysnack foods, and fast foods; and drink less alcohol.

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What are the warning signsof a stroke?A stroke happens when part of your brain isnot getting enough blood and stops working.Depending on the part of the brain that isdamaged, a stroke can cause

• Sudden weakness or numbness of yourface, arm, or leg on one side of your body.

• Sudden confusion, trouble talking,or trouble understanding.

• Sudden dizziness, loss of balance,or trouble walking.

• Sudden trouble seeing in one or both eyesor sudden double vision.

• Sudden severe headache.

Sometimes, one or more of these warning signsmay happen and then disappear. You might behaving a “mini-stroke,” also called a TIA (transient[TRAN-see-unt] ischemic [is-KEE-mik] attack).If you have any of these warning signs, tell yourdoctor right away.

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How can clogged blood vesselshurt my legs and feet?Peripheral vascular (puh-RIF-uh-rul VASK-yoo-ler)disease can happen when the openings in your bloodvessels become narrow and notenough blood gets to your legs andfeet. You may feel pain in yourbuttocks, the back of your legs,or your thighs when youstand, walk, or exercise.

What can I do toprevent or controlperipheral vasculardisease?

• Don’t smoke.

• Keep blood pressureunder control.

• Keep blood fats closeto normal.

• Exercise.

You also may need surgeryto treat this problem.

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Which medical tests will help mekeep track of any heart or bloodvessel problems?

• Have your blood pressure checked every timeyou see your doctor. Ask your doctor whatyour blood pressure is and what it should be.

• Your doctor may order an exercise stresstest to see if you have any problems. Thedoctor will see how your heart performs duringexercise.

• Have your blood fats checked once each year.This checkup includes four tests:

Blood cholesterol. Your number shouldbe 200 or lower.

LDL (bad cholesterol). Your numbershould be 100 or lower.

HDL (good cholesterol). Your numbershould be 45 or higher.

Triglycerides (try-GLISS-er-ides) (the formin which energy is stored in your fat cells).Your number should be 200 or lower.

If your numbers are not normal, ask your doctorif you should take medicine to make them normal.

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For more informationDiabetes Teachers (nurses, dietitians, pharmacists,and other health professionals)

To find a diabetes teacher near you, call theAmerican Association of Diabetes Educatorstoll-free at 1–800–TEAMUP4 (1–800–832–6874),or look on the Internet at www.aadenet.org andclick on “Find an Educator.”

Recognized Diabetes Education Programs(teaching programs approved by the AmericanDiabetes Association)

To find a program near you, call toll-free at1–800–DIABETES (1–800–342–2383), orsee www.diabetes.org/education/edustate2.aspon the Internet.

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Dietitians

To find a dietitian near you, call the AmericanDietetic Association’s National Center forNutrition and Dietetics toll-free at1–800–366–1655, or look on the Internet atwww.eatright.org and click on “Find a Dietitian.”

Government

The National Heart, Lung, and Blood Institute(NHLBI) is part of the National Institutes ofHealth. To learn more about heart and bloodvessel problems, write or call NHLBI Informa-tion Center, P.O. Box 30105, Bethesda, MD20824–0105, (301) 592–8573; or seewww.nhlbi.nih.gov on the Internet.

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More in the seriesThe “Prevent Diabetes Problems” series includesseven booklets that can help you learn more abouthow to prevent diabetes problems.

For free single copies of these booklets, call, write,fax, or email the

National Diabetes Information Clearinghouse1 Information WayBethesda, MD 20892–3560

Phone: 1–800–860–8747 or (301) 654–3327Fax: (301) 907–8906Email: ndic@info.niddk.nih.gov

These booklets are also available under “HealthInformation” at www.niddk.nih.gov on the Internet.

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AcknowledgmentsThe National Diabetes Information Clearinghousethanks the people who helped review or field-testthis booklet.

For AmericanAssociation of DiabetesEducatorsLynn Grieger, R.D.,C.D.E.Arlington, VTCelia Levesque, R.N.,C.D.E.Montgomery, ALTeresa McMahon,Pharm.D., C.D.E.Seattle, WABarbara Schreiner, R.N.,M.N., C.D.E.Galveston, TX

For American DiabetesAssociationPhyllis Barrier, M.S.,R.D., C.D.E.Alexandria, VALinda Haas, Ph.C., R.N.,C.D.E.Seattle, WAKathleen Mahoney,M.S.N., R.N., C.D.E.Drexel Hill, PARandi Kington, M.S.,R.N., C.S., C.D.E.Hartford, CT

Diabetes Research andTraining CenterAlbert EinsteinSchool of MedicineNorwalk HospitalNorwalk, CTJill Ely, R.N., C.D.E.Sam Engel, M.D.Pam Howard, A.P.R.N.,C.D.E.

Diabetes Research andTraining CenterIndiana UniversitySchool of MedicineIndianapolis, INMadelyn Wheeler, M.S.,R.D., F.A.D.A., C.D.E.

Diabetes Research andTraining CenterVA/JDF DiabetesResearch CenterVanderbilt School ofMedicineNashville, TNOk Chon Allison,M.S.N., R.N.C.S.,A.N.P., C.D.E.Barbara Backer, B.S.James W. Pichert, Ph.D.Alvin Powers, M.D.Melissa E. SchweikhartMichael B. SmithKathleen Wolffe, R.N.

Grady Health SystemDiabetes ClinicAtlanta, GAErnestine Baker, R.N.,F.N.P., C.D.E.Kris Ernst, R.N., C.D.E.Margaret Fowke,R.D., L.D.Kay Mann, R.N., C.D.E.

Health Care FinancingAdministrationBaltimore, MDJan Drass, R.N., C.D.E.

Indian Health ServiceAlbuquerque, NMRuth Bear, R.D., C.D.E.Dorinda Bradley, R.N.,C.D.E.Terry Fisher, R.N.Lorraine Valdez, R.N.,C.D.E.

Indian Health ServiceRed Lake, MNCharmaine Branchaud,B.S.N., R.N., C.D.E.

Medlantic ResearchCenterWashington, DCResa Levetan, M.D.

Texas Diabetes CouncilTexas Departmentof HealthAustin, TXLuby Garza-Abijaoude,M.S., R.D., L.D.

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National DiabetesInformation Clearinghouse

1 Information WayBethesda, MD 20892–3560Phone: 1–800–860–8747 or (301) 654–3327Fax: (301) 907–8906Email: ndic@info.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC)is a service of the National Institute of Diabetes andDigestive and Kidney Diseases (NIDDK). NIDDKis part of the National Institutes of Health under the U.S.Department of Health and Human Services. Establishedin 1978, the clearinghouse provides information aboutdiabetes to people with diabetes and to their families,health care professionals, and the public. NDIC answersinquiries; develops and distributes publications; and worksclosely with professional and patient organizations andGovernment agencies to coordinate resources aboutdiabetes.

Publications produced by the clearinghouse are carefullyreviewed for scientific accuracy, content, and readability.

This publication is not copyrighted. The clearinghouseencourages users of this booklet to duplicate anddistribute as many copies as desired.

This booklet is also available under “HealthInformation” at www.niddk.nih.gov on the Internet.

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U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICESNational Institutes of Health

National Institute of Diabetes andDigestive and Kidney Diseases

NIH Publication No. 00–4283May 2000