and the heartDiabetes

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• Type 1 diabetes accounts for a small proportion of diabetics and occurs when part of the pancreas stops producing insulin. It develops rapidly, with clear symptoms, usually before the age of 40, and is managed with insulin injections, a healthy balanced diet and regular exercise. • Type 2 diabetes is the most common type and develops when the pancreas does not make enough insulin or cells don’t respond to insulin as well (insulin resistance). It develops more slowly, with less noticeable symptoms than type 1 and so is harder to diagnose. It usually affects people over the age of 40, although young people and even children are increasingly being diagnosed. It is strongly associated with obesity. Type 2 can be managed by diet, exercise and weight loss, although oral medication or insulin injections are sometimes needed.

Diabetes is a condition where there are problems with the control of blood glucose or sugar. With diabetes, blood glucose is too high, because the body’s cells can’t take it up and convert it into energy as normal. Often, this is because the body doesn’t produce enough insulin, a hormone released by the pancreas that stimulates cells to take up glucose. It can also be because the body’s cells have become ‘resistant’ to the action of insulin. There are two types of diabetes:

at riskYou are more likely to develop type 2 diabetes if you: • are overweight • are apple-shaped • have a parent or sibling with type 2 • are of South Asian or African-Caribbean origin • have been diagnosed with metabolic syndrome* • have had diabetes during pregnancy (gestational diabetes) • have given birth to a large baby (over 9lbs or 4kg) • have Polycystic Ovary Syndrome and are overweight * metabolic syndrome is where people have several risk factors at once, like a high waist measurement, high blood pressure, raised cholesterol levels and insulin resistance

symptoms of diabetes• increased thirst • passing urine more frequently • tiredness • urinary infections • blurred vision • unexplained weight loss • skin infections or thrush

These symptoms may not all happen at once and aren’t a definite indication of diabetes; consult your doctor if you have any concerns.

diabetes and heart diseaseIf not carefully managed, diabetes can increase the risk of developing coronary heart disease, stroke and circulatory problems and can lead to complications with eyes, kidneys and nerves. Diabetes also worsens the effects of other risk factors for heart disease, like high blood pressure, high cholesterol levels, obesity and smoking.

Keeping your blood glucose levels controlled is essential as glucose levels that are consistently high can affect the lining of arteries and promote the build up of fatty deposits. This can make arteries narrower, reduce the blood supply to the heart muscle and increase blood pressure, all of which increase the risk of having a heart attack, stroke and peripheral artery disease.

If you have diabetes, you are not alone as two and a half million people in the UK have diabetes and many more are thought to be undiagnosed. The sooner you make changes to your lifestyle and take any necessary medication, the sooner you can reduce your risk of heart disease.

preventionSome people can be insulin resistant or ‘pre-diabetic’, where they have higher than normal glucose levels but are not yet diabetic. These people are usually overweight or obese, physically inactive and many go on to develop full-blown diabetes. By taking steps to lose excess weight, exercise more and eat healthily, the progression on to type 2 diabetes and the complications it brings could be avoided.

good management and prevention

By making the right lifestyle choices and being aware of the risk factors, you can help prevent diabetes, delay its onset and manage your diabetes better. At the same time, you will significantly reduce your risk of heart disease.

Choosing a heart-healthy lifestyle is especially important if you have high blood pressure or some of the other risk factors for heart disease.

under control healthy blood glucose levels Keeping them within the normal range every day will help prevent and delay blood vessel damage. Blood glucose levels should fall between 4 to 6 millimoles per litre (mmol/L) before meals and stay below 10 mmol/L two hours after a meal. Get to know how your body responds to meals, exercise, stress and other events. Take your medication as prescribed and follow your GP and nurse’s advice, which will be particular to you.

healthy blood pressure High blood pressure is twice as common in diabetics, so get it checked regularly and take measures to keep it at a healthy level, ideally below 130/80 mmHg.

healthy blood fats Diabetics often have high levels of fats in the blood (triglycerides and cholesterol), which increases their risk of heart disease. These can be controlled with medication, but also by eating a heart-healthy diet, losing any excess weight and exercising regularly.

target waists less than

women 32 inches (82 cm)

men 37 inches (94 cm)

asian men 35 inches (88 cm)

✓ build up slowly and aim for 30 minutes a day with an activity that increases your heart rate, makes you slightly out of breath and gives you a warm glow

✓ you can exercise in shorter instalments, like three 10 minute sessions, and enjoy yourself by varying the type of activity: from walking, cycling, swimming, dancing to doing the housework and gardening with gusto

✓ check with your doctor what is the best level of activity to start with and how to fine-tune your diabetic treatment and snacks to your exercise regime

✓ as you get fitter, try and increase your stamina by exercising for longer spells

✓ join a club or bring a friend along for company and motivation

lifestyle changes that count

♥ a healthy weight and waist measurement Excess weight, especially if carried around your middle (apple shape), can make insulin less effective in controlling your blood sugar levels and can lead to high blood fats and high blood pressure. Reducing your waist measurement and body fat will help prevent diabetes and heart disease. Get a tape measure out and start losing any excess weight, slowly but surely. 1 to 2 lbs (0.5 to 1kg) a week will soon make a difference to your waist measurement and is best achieved by increasing exercise and reducing your food intake.

♥ exercise regularly Regular physical activity will help to regulate your blood glucose levels and make insulin more effective. It will also improve circulation, lower blood pressure, promote weight loss, lower body fat, strengthen muscles and bones, boost energy levels and relieve stress. Find an activity you enjoy doing and make exercise a part of your day.

At Alere™, we believe in empowering individuals to take charge of improving their own health. Alere™ products provide doctors and patients access to the right information at the right time.

Heart Research UK is a national charity funding pioneering research into the prevention, treatment and cure of heart disease. We also support community-based lifestyle projects encouraging people to look after their heart health.

For more information contact us on 0113 297 6206 or email us at lifestyle@heartresearch.org.uk

Visit our website www.heartresearch.org.uk

Registered charity no. 1044821. Heart Research UK, Suite 12D, Joseph’s Well, Leeds LS3 1AB.

more information Other Heart Research UK leaflets are available on the following topics

healthy heart advice healthy eating | blood pressure cholesterol | exercise | stress fats and the heart | smoking women and their hearts

Whether you are pre-diabetic or have diabetes, make sure you invest in a healthy lifestyle. Keep your blood glucose, cholesterol levels and blood pressure healthy for the benefit of your heart, arteries, eyes and kidneys. Make a heart-healthy lifestyle a way of life to help you live life to the full.

♥ a heart-healthy balanced diet

✓ regular healthy meals based on a wide variety of foods and smaller portion sizes are important for keeping blood sugar levels steady and helping to lose weight

✓ a third of your energy each day should come from starchy foods, preferably low Glycaemic Index (GI) foods that cause a slower rise in blood glucose levels when digested. Foods like porridge, brown rice, mixed grain bread, pasta, sweet potatoes, peas, beans and lentils are low GI

✓ choose foods that are high in fibre, which leave you feeling full and promote healthier cholesterol levels

✓ make sure you have at least five portions of fruit and vegetables each day and keep your selection colourful and varied

✓ cut down on total fat, saturated fat, sugar and salt and watch out for the hidden amounts in processed foods by checking food labels

✓ include monounsaturated fats found in foods such as oily fish, nuts, olive and rapeseed oil, instead of fatty cuts of meat, cheese, butter and lard that are high in saturated fat

✓ if you need a snack, choose from chopped raw vegetables, rice cakes, low-fat yoghurts or plain popcorn

✓ special diabetic foods aren’t necessary in a healthy diabetic diet; they can be high in calories, fat and salt and are often expensive

✓ moderate your alcohol intake - up to 2 units a day for women and 3 for men. Remember that alcohol is high in calories. Drink at meal times and check with your doctor that it won’t interfere with your medication

♥ stop smoking Ditch that extra burden of chemicals that is so damaging to your heart and arteries and increases the risk of complications if you are diabetic. Get advice and support on successful quitting and enjoy all the benefits that come with a smoke-free lifestyle