Diabetes Health Talk

American Diabetes Association

1) Don’t forget your ABCs
Healthy A1C, blood pressure, and cholesterol levels are important to good diabetes control. This year’s Scientific Sessions reinforced this message. Three major studies presented at the meeting looked at tight blood glucose control and cardiovascular disease, such as heart attack and stroke. While each study had somewhat different research objectives and patient populations, they all showed that people with diabetes must maintain healthy ABCs to prevent both types of diabetes complications — microvascular (kidney disease, blindness, and nerve damage) and macrovascular (heart disease and stroke).

So just in case you forgot, here are your ABC’s.

A is for A1C. The A1C test–short for hemoglobin A1C–measures your average blood glucose (sugar) over the past 3 months.
How often: At least twice a year

B is for blood pressure. High blood pressure makes your heart work too hard and can cause damage to your kidneys and eyes.
How often: At every visit

C is for cholesterol. Bad cholesterol, or LDL, builds up and clogs your arteries, leading to heart attacks and strokes.
How often: At least once a year

Talk to your health care team to see if these levels are attainable for your personal health goals.

2) Brush your teeth!
Just as with any other infection, if you have periodontal (gum) disease, it’s more difficult to control your diabetes — but people don’t make the connection. Emerging research presented at ADA’s meeting indicated that healthy teeth and gums are important not only for oral health but also for the body’s overall health. It is estimated that people with diabetes are 2 to 5 times more likely to develop periodontal (gum) disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. People who do not have their diabetes under control are especially at risk.

3) You might not need those expensive tests
Angina is the normal warning sign of a shortage of blood flow to the heart. However, due to a common form of nerve damage (neuropathy) in people with diabetes, that “warning” pain is often not felt or may only be experienced at such a low level that it is not perceived as a warning. This is known as silent ischemia.

A study at the Scientific Sessions explored whether doctors should perform regular, and expensive, myocardial perfusion imaging (MPI) screening on people with type 2 diabetes. The researchers separated the study participants into two groups, one that had the screening and one that didn’t.

The results were surprising. Only 22% of the screened group had silent ischemia. After an average of 4.8 years, about 2.8% had cardiac events. Those found to have defects at the outset had their doctors informed; some likely took action, which probably lowered their event rate. In the non-screened group, researchers can assume that about 22% probably also had MPI defects. So why didn’t they have a higher event rate? This suggests normal clinical care is catching potential problems and expensive screening may not be necessary.