Playing the Numbers Game:
Diabetes and Heart Disease

By Bev Bromfield

What does playing the numbers game mean?

“It means knowing your numbers and how they relate to your health and risk for developing diseases such as diabetes and heart disease,” explains Judy Fry, registered nurse and certified diabetes educator with Salem Hospital’s Diabetes Education Program. “Numbers are key to maintaining a healthy lifestyle through knowledge about glucose, blood pressure, and cholesterol levels.”

Knowledge of blood glucose levels can indicate whether you are at risk for diabetes or actually have diabetes. Diabetes is diagnosed when a fasting blood glucose level is equal to or greater than 126 mg/dL on two different occasions. Maintaining elevated blood glucose levels of 140 mg/dL and higher contributes to the development of complications such as heart disease, blindness, kidney disease, and nerve damage. If diagnosed with diabetes, maintaining blood glucose values close to normal helps reduce or prevent development of complications. Normal blood glucose values for anyone not diagnosed with diabetes or pre-diabetes are less than 100 mg/dL.

Pre-Diabetes (“borderline” or impaired fasting glucose) occurs when blood glucose values are 100 to 125 mg/dL. Having a glucose value of 125 mg/dL means you are at high risk for developing diabetes. Studies show that if modest lifestyle changes are not implemented, most people with pre-diabetes develop type 2 diabetes within 10 years. Modest lifestyle changes include being physically active for 30 minutes a day and losing 5 to 7 percent of body weight.

A recent study entitled DREAM (Diabetes REducation Assessment with ramipril and rosiglitazone Medication) assessed the impact of medication in preventing diabetes among individuals diagnosed with pre-diabetes. Half of the participants took 8 mg of rosiglitazone while the other half took a placebo.

Rosiglitazone is an oral medication that stimulates cells to produce insulin. Insulin allows glucose to pass into cells, producing energy needed by the body to function. People with pre-diabetes and type 2 diabetes are unable to properly metabolize glucose produced by food and drink, due to a lack of enough insulin or resistance to insulin. The DREAM study found participants taking rosiglitazone, along with a healthy diet and exercise, were 62 percent less likely to develop diabetes and 70 percent more likely to return to normal blood glucose levels.

Studies show that people diagnosed with diabetes who maintain a blood pressure of less than 130/80 have 50 percent fewer heart attacks and strokes. Blood pressure levels should be checked at every doctor visit. Ideally, blood pressure should be maintained at 120/80 to avoid cardiovascular risks associated with high blood pressure. Blood pressure can be lowered by losing weight and reducing salt intake in the diet.

Knowing your cholesterol levels can also reduce your risk of cardiovascular disease. To avoid narrowing of the arteries and hardening of the arteries, it is important to maintain LDL (the bad cholesterol, low-density lipoprotein) at less than 100 mg/dL and HDL (good cholesterol) at greater than 40 mg/dL. The HDL (high-density lipoprotein) collects excess cholesterol in the blood and takes it to the liver where it gets broken down.

Additional risk factors that can contribute to development of cardiovascular disease and type 2 diabetes include obesity, high blood fats (triglycerides greater than 150 mg/dL), smoking, and physical inactivity. Each of these risk factors poses a danger to good health. The more risk factors one has, the greater the risk for heart disease and type 2 diabetes.

To help maintain appropriate cholesterol levels, limit the intake of saturated fat to less than 7 percent of daily calories. Eat at least 20 to 30 grams of fiber a day. Fiber can be found in whole grains, vegetables, fruit with skin, and dried beans. If needed, medication may be added to further reduce risk of cardiovascular disease.

“We all need to play the numbers game,” says Fry. “The numbers will guide you into making better health decisions. If glucose levels are high, it’s time to take a look at the numbers to help identify why and what to do. Equally important are the numbers for blood pressure as well as the recommended levels for cholesterol, LDL, HDL, and triglycerides. Using numbers to implement potential action is invaluable to making appropriate health decisions. Protecting the working parts that keep the body going should be a high priority.”

Take a step towards knowing your numbers and what they mean. This can take you a long way toward attaining optimal health. For more information, visit www.diabetes.org or call your local American Diabetes Association at 1-800-DIABETES.

Bev Bromfield is the Program Manager for the American Diabetes Association in Oregon and Southwest Washington.