There’s no disputing the statistics: Adults with diabetes are nearly twice as likely to develop heart disease or stroke as those who don’t have the disease. That’s why it’s crucial for diabetic patients to be proactive.
Robert Gabbay, M.D., Ph.D.
Chief Scientific and Medical Officer, American Diabetes Association (ADA)
“There are many steps people with diabetes can take to reduce their heart disease and stroke risk,” explained Robert Gabbay, M.D., Ph.D., who before joining the American Diabetes Association served as the chief medical officer and senior vice president of Joslin Diabetes Center, the world’s leading diabetes care and research center. “For example, if they are smoking, they need to quit. Also, make smarter food choices, prevent or treat their high cholesterol and high blood pressure, be more physically active, lose weight, and better manage their diabetes.”
Who’s at risk
According to Dr. Gabbay, who’s also an associate professor at Harvard Medical School, certain individuals are more likely to develop diabetes.
“We screen people who are 45 or older, of certain ethnic backgrounds, have a first-degree family member with diabetes, are overweight or obese, are physically inactive, have low good cholesterol (HDL) and high bad cholesterol (triglycerides), have a history of diabetes during pregnancy, or have been diagnosed with polycystic ovarian syndrome,” he said.
The American Diabetes Association® offers a free 60-second risk test, available at diabetes.org/RiskTest, that you can take to assess your likelihood for developing diabetes.
Don’t go overboard
Instead of making dramatic changes or taking part in fad diets, Dr. Gabbay believes patients with diabetes, or those who are at risk, should take a more sensible approach.
“Studies have shown that a weight change of only 5-7 percent can have a drastic effect on people’s health,” he said. “My suggestion as it pertains to diet is to have people at risk for diabetes work with a dietitian and their healthcare team to improve what we call their ‘dietary pattern.’”
A dietary pattern looks at the quantities, proportions, variety, and a combination of different foods, drinks, and nutrients and how often they are habitually consumed. Once determined, patients can work with their dietitian or healthcare team to make improvements.
Cardiovascular disease remains the leading killer in America. For people living with diabetes, it’s essential to remember that heart disease can show no signs at all.
“For women, heart disease may have different signs from what we are used to with men, like chest pain,” Dr. Gabbay points out. “Women can get arm pain, jaw or back pain, or other symptoms instead. Educating people with diabetes and women who are at risk for having heart disease about how their symptoms may appear is very important.”
Dr. Gabbay says close follow-up with a healthcare team is also critical in preventing and managing cardiovascular events appropriately.
Dealing with COVID-19
During the pandemic, researchers have studied activity levels in many countries across the globe, and the numbers are universally down. Dr. Gabbay says programs to increase activity should focus on safe restoration and improvement of previous exercise levels. He’s also concerned about fewer people getting tested for cardiovascular disease.
“We are still in the COVID-19 pandemic and, unfortunately, an indirect effect is that fewer people were being diagnosed with heart disease, as many have avoided hospitals during the COVID-19 surges,” he said. “That definitely does not help with avoiding deaths due to heart disease. However, efforts to combat this disease are ongoing, and should be intensified during and after the pandemic.”
Gabbay adds that we need to all work together to ensure that the various steps and treatments that can prevent heart disease, like better management of the ABCs (A1C, blood pressure, and cholesterol) are taken.