Type 2 Diabetes and Your Heart: A Primary Care Guide for Boca Raton Patients
Diabetes is often discussed in terms of blood sugar, but one of its most important effects is on the heart and blood vessels. People with diabetes have a higher risk of heart attack, stroke and circulation problems, and that risk grows when diabetes travels with high blood pressure and high cholesterol. This guide from South Florida Heart and Vascular Institute (SFHVI), the Boca Raton primary care and heart health practice of Bruce Wishnov, DO, explains the connection and the steps that protect your heart.
How diabetes affects the heart and blood vessels
Over time, high blood sugar can damage the lining of blood vessels and the nerves that control the heart and circulation. This makes it easier for plaque to build up in arteries (atherosclerosis), which can narrow the vessels that feed the heart, brain and legs. Diabetes also often comes with other risk factors, including high blood pressure, abnormal cholesterol, excess weight and kidney disease, and each one adds to the strain on the cardiovascular system.
Because of nerve changes, some people with diabetes have less typical heart symptoms. Shortness of breath, unusual fatigue, nausea or discomfort in the jaw, arm or back can be signs of a heart problem and should not be ignored.
The key tests
A1C
The A1C blood test reflects your average blood sugar over roughly the past two to three months. It is used both to diagnose diabetes and to track how well treatment is working. For many nonpregnant adults with diabetes, guidelines from the American Diabetes Association suggest a goal below 7%, but the right target depends on your age, other health conditions and risk of low blood sugar. Your doctor will set a goal that fits you.
Blood pressure
Blood pressure should be checked at every visit. For many people with diabetes, current guidelines suggest a target below 130/80 mm Hg if it can be reached safely. Home monitoring can help you and your doctor see the full picture.
Cholesterol
A lipid panel measures LDL, HDL, triglycerides and total cholesterol. Many adults with diabetes are candidates for cholesterol-lowering therapy based on their overall risk. Our earlier article explains how to understand your cholesterol numbers.
Kidney tests
Diabetes can damage the kidneys, and kidney disease raises heart risk. A yearly urine albumin test and a blood test for kidney function (eGFR) help catch problems early.
Other routine checkups
- Dilated eye exam, usually once a year, to look for diabetic eye disease.
- Foot exam at least yearly, and a quick look at your feet at every visit, to check sensation, circulation and skin.
- Dental checkups, because gum disease is more common with diabetes.
- Vaccines recommended for adults with diabetes, such as flu and pneumonia vaccines, as advised by your doctor.
Everyday steps that protect your heart
- Eat a balanced plate: half non-starchy vegetables, a quarter lean protein and a quarter whole grains or starchy foods, with water or unsweetened drinks.
- Move regularly. Many adults are advised to aim for about 150 minutes a week of moderate activity, such as brisk walking, spread over several days, plus some strength training, if your doctor agrees.
- Stop smoking. Smoking and diabetes together sharply increase cardiovascular risk. Florida's free Tobacco Free Florida program can help you quit.
- Take medications as prescribed. Some newer diabetes medications have been shown to offer heart or kidney benefits for certain patients; ask whether they are appropriate for you.
- Sleep and stress: poor sleep and chronic stress can make blood sugar harder to control. Ask about evaluation if you snore heavily or feel tired during the day.
Recognize low and high blood sugar
If you take insulin or certain oral medications, learn the signs of low blood sugar: shakiness, sweating, confusion, rapid heartbeat or hunger. Ask your doctor how to treat it. Very high blood sugar may cause extreme thirst, frequent urination and fatigue. Call your doctor for readings outside the range you have been given, and call 911 for confusion, fainting or trouble breathing.
When a cardiology evaluation makes sense
Your primary care doctor may recommend heart testing or a cardiology referral if you have chest discomfort, shortness of breath with activity, palpitations, leg pain when walking, an abnormal EKG or several risk factors together. SFHVI offers heart-health screening and cardiology referral alongside primary care, so these steps can be coordinated in one place. Learn more about cardiology at SFHVI.
Common questions
How often should my A1C be checked?
Many people with diabetes have it checked two to four times a year, depending on how stable their blood sugar is and whether treatment has changed. Your doctor will recommend a schedule.
Can type 2 diabetes be managed without medication?
Some people can reach their goals with changes in eating, activity and weight, at least for a time. Many others need medication, and that is not a failure. The goal is to protect your heart, kidneys, eyes and nerves.
Diabetes care in Boca Raton
South Florida Heart and Vascular Institute provides primary care in Boca Raton, including diabetes care, hypertension and cholesterol management and chronic care management. Our office is at 22065 State Road 7, Boca Raton, FL 33428. To schedule, request an appointment or call 561-488-4847. SFHVI is part of the Advanced Health Associates group.
This article is for general education and is not a substitute for medical advice, diagnosis or treatment. Do not change your medications without talking to your doctor. If you have chest pain, trouble breathing or signs of a stroke, call 911.
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