Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.
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11 SHUTTERSTOCK at age 45, start having a blood test [for blood glucose]," Dr. Chaudhuri explains. People with a family history of Type 2 diabetes, and women who had gestational diabetes or gave birth to a large child, or who are Asian American, African American or Native American, should be checked at younger ages, according to Dr. Chaudhuri. ADDING IN THE HEART FACTOR When Type 2 diabetes is diagnosed in a patient, "we treat them as if they've already had a heart attack even if they haven't," says Dr. Chaudhuri. That means aggressively addressing high blood glucose levels, blood pressure and cholesterol issues. "We have to control all three to provide maximum protection against heart disease. You have to not only be concerned with medications for diabetes but watch your blood pressure and cholesterol levels," Dr. Chaudhuri says. In fact, patients who have both hypertension and diabetes are at double the risk for cardiovascular disease, according to the AHA. In addition, having low HDL ("good") cholesterol, high LDL ("bad") cholesterol and high triglycerides is an unhealthy combination often found in people with diabetes and is linked to coronary heart disease. LONG-TERM DIABETES MANAGEMENT Women with diabetes should monitor their blood sugar levels, get more exercise (even if it doesn't mean a gym routine), quit smoking if that's a habit, and work with their physicians to get their cholesterol and blood sugar levels down, advises Dr. Chaudhuri. Medications are important, he says, but he recommends focusing on achieving health goals as the top priority. Still, over time your medical practitioner may need to change the drugs or dosages you're taking. Don't interpret that as a sign of failure, says Dr. Chaudhuri. "I want people with diabetes to have a sense of optimism," he says. "Take this opportunity to give yourself the motivation to change your lifestyle. Once you're under control, you have a lot to look forward to." • I f you or someone you love has been diagnosed with Type 2 diabetes, managing common symptoms like fatigue and increased hunger may be your most immediate concerns. What you may not be aware of, however, is that heart disease and stroke are also linked to diabetes. Health experts want patients to make that connection, because adults with Type 2 diabetes are two to four times more likely to have heart disease or a stroke compared with adults who do not have diabetes, according to the American Heart Association. "The commonest cause of death in people with Type 2 diabetes is heart attack, heart failure or stroke," says Dr. Ajay Chaudhuri, medical director of the Diabetes Center at Kaleida Health, Williamsville, N.Y. And women who have diabetes are at even greater risk for a stroke or cardiovascular events, according to Dr. Kimberly Rieniets, an endocrinologist at North Colorado Medical Center, Greeley, Colo. SCREEN SCENE Physicians urge women to be vigilant, advocating screening and treatment for diabetes and heart disease risk factors at the same time. Because Type 2 diabetes is a "silent killer" that can take 10 years to fully develop, screening is essential, says Dr. Chaudhuri, also a professor of medicine at State University of New York at Buffalo. "The big concern is what can we do to decrease the proportion of women with diabetes who are unaware they have the disease," says Dr. Rieniets. "A fasting blood sugar over 125 [fasting plasma blood glucose level over 125 mg/dl] would give you a diagnosis, but it has to be followed up with a second test." "Right now the recommendation is Women with prediabetes, a condition in which blood glucose levels are higher than normal but not high enough to be classified as full-blown diabetes, are also at greater risk for heart disease or stroke, according to Dr. Ajay Chaudhuri at Kaleida Health, Williamsville, N.Y. "We want to catch blood sugar abnormalities as quickly as possible; 120 to 124 [fasting plasma blood glucose level of 120-124 mg/dl] is considered prediabetes," says Dr. Kimberly Rieniets at North Colorado Medical Center in Greeley. However, even with prediabetes you can significantly reduce your risk or delay the onset of diabetes. "Really working hard with nutrition, diet and exercise can make a real impact," says Dr. Rieniets. Prediabetes and heart disease risk The unpredictable shape of diabetes About 80 percent of people with Type 2 diabetes are overweight or obese, according to the government's National Institute of Diabetes and Digestive and Kidney Diseases, but there are exceptions. Physicians look at more than body mass index (BMI) when urging blood sugar testing. They're also concerned with a concentration of weight around the midsection. "Having central adiposity may not be overweight, but too much fat around the middle is the worst fat to have in terms of metabolic health. It definitely increases the risk of diabetes," says Dr. Kimberly Rieniets at North Colorado Medical Center. "If you're not overweight, don't think you don't have to have regular blood sugar tests."