Features September 2014 Issue

Study: Undiagnosed Diabetes a Factor in Many Heart Attacks

Other research suggests additional threats to cardiovascular health caused by excessive sugar consumption.

An estimated 10 percent of people who have a heart attack may have undiagnosed diabetes. Researchers presenting their findings at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2014 also noted that less than a third of those diagnosed with diabetes during hospitalization received diabetes education or diabetes medications at discharge.

To lower your heart attack risk, get checked for diabetes. If you have diabetes, treat it aggressively.

The study results don’t surprise Cleveland Clinic endocrinologist and diabetes expert Betul Hatipoglu, MD. She points out that the U.S. Centers for Disease Control and Prevention estimate that seven million Americans have diabetes but aren’t aware of their condition.

“Heart disease, particularly coronary heart disease, is a major cause of death among patients with diabetes,” Dr. Hatipoglu says. “Pre-diabetes or overt diabetes increases risk of acute MI (heart attack). Patients are more likely to be tested during their hospitalization or emergency room visit, and be diagnosed with previously unrecognized diabetes during their medical care for an acute event.”

She adds that the stress of a heart attack could worsen the tendency toward high blood sugar and unmask the disease that might have been silent up to that point.

Diabetes and heart attack
If you have diabetes, you’re probably well aware of the heart risks associated with the disease. Controlling your diabetes symptoms, such as your circulating blood glucose level, is essential to reduce the risk of heart attack and other complications.

“Patients with diabetes have an increased number of risk factors linked to atherogenic disease compared to nondiabetics, including obesity and lipid abnormalities,” Dr. Hatipoglu says. “Many of these risk factors are even present before full-blown diabetes occurs as in pre-diabetes.”

If you haven’t been diagnosed with diabetes, Dr. Hatipoglu says, it’s “absolutely crucial” to be screened for the disease if you have risk factors such as obesity, lipid abnormalities (high LDL cholesterol or triglycerides), hypertension or advanced age. A few simple blood tests can reveal your blood glucose levels and determine whether you have diabetes.

Added sugar risks
The risks of too much sugar in your diet may extend beyond weight gain and diabetes. A study out of New Zealand, published in the American Journal of Clinical Nutrition, found that greater consumption of added sugars can raise heart disease risk factors, independent of weight gain. Researchers noted added sugars are associated with higher blood pressure and higher lipid levels even if your weight remains relatively stable.

“Triglycerides are fats in the blood caused by eating too many calories, specifically sugar and fat calories,” explains dietitian Julia Renee Zumpano, RD, LD, with Preventive Cardiology and Rehabilitation at Cleveland Clinic. She adds that weight gain is, of course, also a major result of too much sugar.

“Read labels and avoid added sugars and high-fructose corn syrup,” she recommends.

“Choose water, unsweetened tea or coffee, or diet drinks. Try to limit added sugars to two or three teaspoons per day.

Get educated
Those behaviors should continue if you do develop diabetes. Dr. Hatipoglu says education about diet, exercise and medications is critical to managing diabetes.

“We try to provide diabetes education to our newly diagnosed patients while they are still in the hospital,” she says. “But of course it is a lot to take in at one time. Sometimes they might not be ready. They just survived a heart attack and its consequences, and diabetes is an additional burden for them. Nevertheless, we try to provide enough educational material about healthy lifestyle, dietary information, as well as a glucose meter to follow their progress upon discharge.”

If you feel you’re not getting enough diabetes education from your doctor, ask for more and see about consulting with a dietitian for tips on healthier eating.

What you can do
- Have your blood glucose levels checked annually, or more frequently if your doctor advises it.
- Talk with your doctor about what you can do to bring down your blood glucose levels or better control symptoms if you already have diabetes.
- Reduce your intake of added sugars by avoiding or at least minimizing your consumption of sodas, sweetened sports drinks, and desserts or snacks packed with added sugars.

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