Diabetes and Heart Attack

Diabetes is a matter of good control. The diabetic is at several disadvantages where heart disease is concerned. Diabetics have trouble in getting glucose to where it is needed - the tissues and muscles. For one reason or another, they lack the hormone insulin which shifts the glucose out of the bloodstream into tissues. This means that in untreated or poorly controlled diabetes, the glucose^ levels in the blood are very high. This not only leads to a sluggish blood flow through the smaller blood vessels, as explained earlier, but it also disturbs the way the body fats are used.

The result is that most diabetics have very high LDL-cholesterol levels in the blood, and that leads to a state of atheroma that is much more severe than normal. So diabetics not only have to control their glucose levels very carefully, by using insulin and watching what they eat, they also have to take particular care of their fat levels. Over and above that, however, we now know that too much insulin can also do them harm. It helps to cause problems in the smallest blood vessels in the kidneys, eyes and skin.

Fortunately for all diabetics, there has been real progress in the treatment of the disease in the last ten years. Probably the biggest step forward has been the switch to a high fiber, low fat and low protein diet. This, along with eating many small meals a day, and taking three or four smaller, instead of one or two larger, insulin doses a day, has led to much better control of glucose and insulin levels. That is already reducing the heart attack rates in diabetics regularly attending clinics (those who fall by the wayside and let their control slip do not do so well).

Another big step forward for diabetics is the insulin 'pen'. This spring loaded device with a special needle is so much easier, more accurate and less painful to use than the old needle-and-syringe systems that it should be offered to every insulin-using diabetic. It is especially useful for the teenage diabetic, who finds it less embarrassing than syringes, and that it gives him or her much more freedom to live a normal life. It is crucial that good control habits are learned at an early age, because it is at this time that the seed of later trouble in the heart and blood vessels are sown.

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