As you know, learning and improving self-management skills is key to living well with T1D. Skills can look like adjusting your insulin to your nutrition, but it can also be learning your risk factors to help improve your overall health. In this newsletter, we will focus on your heart health and how to manage your cholesterol and blood pressure levels.
Did you know that living with diabetes increases the risk of heart disease by 2-4 times? In addition, women who live with T1D are at higher risk of heart disease compared to women who do not have T1D. The good news is that there are many ways to decrease the risk of heart disease with a combination of lifestyle changes and prescribed medications.
What is heart disease?
Heart disease (also known as cardiovascular disease) refers to different conditions that affect the heart (examples include heart attack, heart failure and irregular heartbeat). It can also affect our arteries and brain. High blood pressure can also cause damage to the kidneys. There is also a specific type of heart disease that affects the nerves in the heart and is found in those living with T1D. It is called cardiac neuropathy.
How is this monitored, and how often?
Your endocrinologist and/or family physician will check your blood cholesterol levels at a frequency determined specifically for you. This could vary between every 3 months to every 3 years. Blood pressure is checked at every visit, usually every 3-6 months. If you take a blood pressure medication and/or a cholesterol medication, your doctor might want to check your levels more frequently. You can also check your blood pressure if you have a home monitor or at a pharmacy or other facility. This might be a good option for those who experience ‘white coat syndrome’ or feel stress or anxiety prior to a medical appointment.
What are the targets?
Generally, LDL cholesterol (the type that contributes to plaque buildup in the arteries – think of L in LDL for Lousy cholesterol) levels are recommended to be less than 2 mmol/L. Blood pressure targets are generally less than 130/80mmHg.
How are they treated?
It is important to know that medications may be recommended to you despite having normal cholesterol or blood pressure levels. This is normal. Think of these medications as tools to protect the heart and kidneys. The recommendation is based on the increased risk of heart disease and the risk reduction that occurs from the medication. The recommendation is individualized to you and based on how long you have lived with diabetes, family history, your age, family planning, etc. For example, if you are between the age of 30-40 years old and you have lived with T1D for over 15 years, then medications may be recommended for you. If you are over 40 years of age, medications are recommended for most individuals. Do not hesitate to ask your physician or pharmacist if you have any questions. Remember, decisions regarding medication and your health should always include you.
Blood cholesterol and blood pressure levels can also be reduced with the help of small and consistent lifestyle changes. These lifestyle changes not only help cholesterol and blood pressure readings but can also improve your sugar levels, and overall health as well.
Here are some top tips to help reduce your risk:
- Limit sodium intake to less than 2000 mg per day or 5% or less on the food label. Some foods that are higher in sodium include cereal, cheese, deli meats, sauces & condiments.
- Add more soluble fibre to your meals and snacks. When eaten, soluble fibre creates a gel-like substance that can help move things along your digestive system. This can slow your digestion (keep you fuller longer) and can also reduce cholesterol and blood sugar levels. Foods high in soluble fibre include oats, fruits, vegetables, and legumes (beans & lentils).
- Eat more fruit and vegetables. Fruits and vegetables are high in minerals, fibre and water. These nutrients can reduce blood pressure, cholesterol and can help stabilize your sugar levels. Consider pairing your fruit with protein for increased nutrition.
- Add nuts & seeds to your meals and snacks. Nuts that are higher in Omega-3 fats can help reduce cholesterol levels. Omega-3 rich nuts include walnuts and chia seeds. Other nuts like almonds are also high in fibre.
- Switch to whole grain products. Not only are 100% whole grain products higher in fibre, whole grains are also higher in nutrients such as magnesium which can reduce blood pressure.
- Reduce alcohol consumption. In general, drinking alcohol can further increase our risk of high blood pressure and heart disease. Aim for 0-2 drinks per week.
- Move more. Exercise does not need to be overly challenging. Choose something that you enjoy! Aim for 150 minutes of cardio exercise per week and resistance exercise (working your muscles) at least 2 times per week. If 150 minutes is too much, start with a realistic amount of time for you. This can look like a 5–10-minute walk 2-3 times per week. Consider gradually increasing duration and intensity over time.
- It is proven that a small reduction in body weight (as little as 3% of your body weight) can impact our health. Weight management is challenging. Sign up for LMC’s Weight Management Series to learn tips & tricks for weight management: https://app.acuityscheduling.com/schedule.php?owner=15031958
Speak to your diabetes team to learn more about your heart health and to help you implement a goal to help reduce your risks!
