Diabetes mellitus is a chronic disease in which the body either does not produce or improperly uses the pancreatic hormone insulin. Insulin controls the concentration of sugar and the amount of sugar (glucose) absorbed in the cells. Blood glucose is a major energy source for many parts of the body, and is the sole source of energy for the brain.
Excessive blood glucose damages the small blood vessels of the kidneys, heart, eyes, nervous system and capillary network in the periphery. Thus optimal levels of blood glucose is important.
In diabetes mellitus, either insufficiently treated or untreated, can lead to heart disease, stroke, kidney disease, blindness and damage to the nervous system and nerves, especially the lower limbs. Cardiovascular disease and stroke are several times more common in people with diabetes. The incidence of diabetes is increasing every year and it is now ranked the top seventh disease with fatal outcome.
There are three types of diabetes:
- Type 1 – diabetes which is insulin dependent, meaning the patient must receive insulin. At the heart of this disease is an autoimmune process that destroys pancreatic beta cells which causes an absence of circulating insulin that leads to hyperglycemia as a result.
- Type 2 – diabetes which is insulin independent. Patients suffering from this form of diabetes are usually over 40 years of age (the incidence is 65-74 years old) and the majority of them are obese.
- Gestational diabetes – It is diabetes diagnosed first during pregnancy. The disease usually withdraws seven weeks after giving birth because its main cause is pregnancy.
On the other hand, Cardiovascular disease (heart disease) is a class of diseases that involves blood vessels (arteries and veins), or the heart itself. Heart disease may be subtle, and not occur with clear warning signs. This is especially true if you have diabetes mellitus.
Statistics show that nearly two-thirds of people with diabetes have high blood pressure, and people with diabetes are two to four times more likely to have heart disease or stroke than people who do not have diabetes. These diseases often have similar causes, mechanisms and treatments.
Diabetes is a disease in which blood sugar levels are dysregulated and usually above the upper limit. Over time, constantly increasing blood glucose levels will damage the blood vessels, mostly the arteries, making them unable to adequately perform its function. Fat deposits are formed inside of the blood vessels, and atherosclerosis develops rapidly. This blocks blood flow to the heart or brain, and it could lead to a heart attack. Risk of obtaining heart disease, combined with the risk of having diabetes, is further elevated if you have a family history of both illnesses. People with diabetes under the age of 44 are several times more in the risk to have cerebrovascular disease than those who do not have diabetes. In people with diabetes, cardiovascular disease occurs at a very early stage, compared to the rest of the population.
How to Prevent Diabetes?
If you think you are at a higher risk of getting heart disease or diabetes, do not panic. We will guide you through 9 lifestyle changes that will help prevent heart disease and diabetes, and also allow you to manage your health status effectively.
1. Increase physical activity
Physical activity improves insulin sensitivity. This reduces risk of diabetes or improves sugar control in patients with diabetis mellitus. A minimum of 30 minutes of physical activity is recommended, five days a week. If you don’t have time to do all 30 minutes all at once, divide it into ten-minute segments. In addition, it is recommended that you have a light activity after every 30 minutes of “heavy” activity in order to improve your blood sugar level. It is not necessary to spend hours in the gym in order for your body to feel the benefits of physical activity. Thirty-minute fast walks are sufficient in a clean, natural environment. Increase your pulse to 70-80% of maximum capacity, for 30 minutes a day, 5 days a week. Studies have shown that high-intensity exercises are extremely beneficial for preventing diabetes so we recommend doing this form of exercise once a week.
2. Drop the sugar
Sugar comes in many forms. A diet full of empty calories and fast-absorbing sugars, liquid sugar calories from refreshing beverages and juices, refined carbohydrates that are quickly converted to sugar, creates high levels of insulin, leading to type 2 diabetes. Very high insulin levels can lead to heart disease, inflammation, high blood pressure, poor libido, increased risk of cancer and depression. The most important thing to do in order to improve your health is to drastically reduce your intake of sugars and refined carbohydrates. It is advisable to have your blood glucose tested at least three times per year, and you should also try to maintain your blood sugar level with the help of the diet and exercise.
3. Eat healthy foods
Reduce your consumption of food that contains high amounts of saturated fat, carbohydrates, large amounts of salt, such as deep-fried food, fast food and red meat. Instead, focus on foods that are high in fibre, including cereals, vegetables and fruits. This diet also benefits your heart and helps keep your blood sugar levels under control. Unprocessed foods will balance your sugar level, reduce inflammatory processes and oxidation stress, and improve detoxification of your body. Choose from many vegetables and fruits, lots of omega 3 fats, coconut, olive, flax oil (cold squeezed), legumes, seeds, nuts.
4. Keep your blood cholesterol within the normal range
Reduce bad (LDL) cholesterol and maintain desirable HDL (good) cholesterol levels. If you have a cholesterol problem, make sure you speak to your doctor about ways to lower your bad cholesterol to reduce your risk of heart disease. Fat should make up 25-35% of our daily intake, while saturated fat should account for less than 7% of our daily calories. Avoid foods that contain saturated fat as they will increase LDL cholesterol and damage blood vessels. Fish, nuts, and other foods containing omega 3 acids are a good way to bring your cholesterol levels in order.
5. Control your blood pressure
Your blood pressure should ideally be about 120/70 mmHg range. Make sure you check your blood pressure each time you visit your doctor, and if you have high blood pressure, consult your doctor about the ways to control it. It is ideal for people with blood pressure problems to adopt a healthier r lifestyle first. Many doctors believe that in order to successfully lower high blood pressure, it is most important to reduce salt intake and be more physically active.
6. Stop smoking
People who smoke have higher risk of cardiovascular problems and cancer. Thus, to quit smoking is the first step to better health.
7. Make sure you are having enough sleep
Lack of sleep or poor sleep increases the stress level in the body. This raises blood sugar levels and stress hormone levels. This in turn increases the risk of heart attacks, heart failure, hypertension, irregular heart rhythm, and diabetes mellitus. All these potentially increases the risk of stroke. It is therefore important to have 7 to 9 hours of undisturbed and relaxing sleep on a daily basis. Create rituals that will slowly bring you to sleep every night. Herbal therapies, warm baths, room blackouts, silence, and the absence of a screen in the sleeping room help the most people.
8. Control your stress level
If you are exposed to chronic stress, your insulin and stress cortisol levels, which are components of inflammation will rise. This leads to metabolic dysfunction which may result in the development of diabetes mellitus. Eliminating stress entirely is hard but you can learn to control it. Physical activity, meditation, deep breathing, are some of the best ways to control your stress levels.
Prevention is important
If you have risk factors for cardiovascular disease or diabetes mellitus, you should look into prevention or treatment by making lifestyle changes such as eating healthy, avoiding smoking, maintaining regular physical activity and optimal weight.
More severe degree of diabetes mellitus or heart disease will require additional treatment i.e. one or more types of medicines to lower blood sugar, control blood pressure or cholesterol. In even more serious cases, surgery or other medical procedures are required to treat the disease.
The treatment differs for each individual and depends on the type of the disease, other co-existing conditions if any, and with discussion and cooperation of the patient.
To improve compliance of lifestyle management, make a record of your lifestyle changes. Write down what you ate, how much you have engaged in physical activity, and your weight daily or weekly.
We highly recommend doing this as many people become very motivated when they see their results on paper.
If you are at risk for the above condition, consult Dr Gerard Leong at Gerard Leong Cardiology Clinic for early diagnosis and treatment.
Gerard Leong Cardiology Clinic
339 Thomson Road #05-05, Thomson Medical Centre
Singapore 307677
T: 6717 0008
E: clinic@drgerardleong.com