People with type 2 diabetes almost always die from heart disease or stroke, and usually about 10 years before people without diabetes. But if you have diabetes, that doesn’t have to be your fate…if you’re willing to follow a very specific five-point strategy.
This plan, developed from a study of more than 250,000 people with diabetes, is a game-changer because it can put a full, healthy life back within reach, adding 12 to 14 years to the average lifespan of someone with type 2 diabetes. The plan takes aim at the five leading risk factors for heart disease and stroke in people with diabetes—high blood pressure, high LDL cholesterol, little physical activity, insulin resistance and smoking. If you already don’t smoke and/or already get lots of exercise, good for you—you’ve already handled part of the plan. But you can’t get away with stopping there. The cumulative effect of the five points is what reduces heart and stroke risks enough to get you back to “even.”
Do the following, and your chances for a heart attack or stroke will be the same as for someone without diabetes…
Take a statin. These drugs are affordable, widely available, easy to remember to take once a day and have the best evidence of any type of drug that they will quickly reduce your body’s cholesterol levels. Note: Statins aren’t without side effects, and not everyone tolerates them well, but there are many different statins available to try if you do get side effects.
Take metformin. This drug enhances the effects of insulin so that it can better control blood sugar. It has a long, positive track record of effectiveness and safety and is typically the first drug prescribed to patients newly diagnosed with diabetes. Important: If metformin doesn’t do enough to control blood sugar or if, independent of your blood sugar, you develop coronary artery disease or have a stroke, you might want to talk to your doctor about SGLT2 inhibitors and/or GLP-1 receptor agonists, the latest generation of diabetes drugs that reduce the risks for heart disease, stroke and cardiovascular death.
Keep your blood pressure in a healthy range. Check yours at least once a week with a home monitor, sitting upright with feet uncrossed and flat on the floor with your arm resting comfortably on an armrest or table. If your pressure is higher than 130/80, take steps to reduce it, which may require medication. Note: It’s important to point out that obesity often sets the stage for many heart and stroke risk factors because it triggers an escalation of high blood pressure as well as increasing risk for high cholesterol and insulin resistance. A loss of just five to 10 pounds can make a difference in all these health checkpoints.
Get into a regular exercise program. Exercise has been found to normalize the structure of blood vessels, improving circulation and reducing stress on the heart. The effect is immediate and can last for up to 24 hours. Exercise also helps you reduce cholesterol, keep blood sugar in line and knock off any extra weight. Studies have shown the best effects from a combination of aerobic exercise and strength training, but it does not have to be high intensity or exhausting—a brisk walk for 30 minutes most days of the week serves this purpose for most.
Stop smoking. If you still smoke, this could be the hardest of the five steps. If you’ve tried and failed to quit in the past, don’t throw up your hands—try a different approach. Maybe what was lacking in the past was a support system of successful quitters to lean on…or maybe nicotine replacement therapy would do the trick for you. You can get help with both those approaches and others—including the ability to create your own customized “quit plan”—through the federally sponsored website Smokefree. There’s advice for coping with triggers, nicotine withdrawal and blue moods, and support is provided through online chats, smartphone apps, texting programs and social media. There’s even targeted advice specifically for men, women, vets, teens and seniors.