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Heart diseaseImagine that you have been diagnosed with diabetes and hypertension. Your life style is one of high stress and you are single trying to fill a void with lots of activities in addition to a high stress job full of pressure to meet performance expectations. Your job stress just increased over the past few months because of the number of layoffs. Then in addition your eating habits have grown worse even though you know you should be doing better.  You know there are risks in not taking care of your health, but your commitments and lifestyle have placed such great demands that you tend to ignore them.

Sudden death has been associated with diabetes although there is no firm evidence based research to link it yet. In a study published in the Cardiology Journal Daniel Bergner and Jeffrey Goldberg concluded that, “diabetes mellitus does appear to be associated with an increased risk of sudden cardiac death. [1]Sudden cardiac death has been the first cardiac event in approximately 55% of men and 68% of women.[2]What makes this even worse is that there is no single test that can identify if you are a candidate for sudden cardiac death. However, there are plenty of things you can look at that can help you to minimize your risk for cardiac disease and diabetes.  “Potential factors contributing to the increased risk of sudden cardiac death observed in patients with diabetes mellitus include silent myocardial ischemia, autonomic nervous system dysfunction, abnormal cardiac repolarization, hypoglycemia, a hypercoaguable state secondary to diabetes mellitus, diabetic cardiomyopathy, and impaired respiratory response to hypoxia and hypercapnea.[3]

You need to talk with your doctor on a frequent basis.  Most of us think about going to the doctor as an annoyance or as something you do when you are sick but for diabetics the world is slightly different and frequent visits can help you to measure lipids, cholesterol, hypertension, A1C levels, and other indicators that can make the difference in a long life or a short one. In addition you will want to talk with your doctor about promptly initiating ACE inhibitors, angiotensin receptor blockers, beta-blockers, antiplatelet agents (aspirin), and possibly statin therapy for CAD, hypertension, and/or hypercholesterolemia. While these can seem foreign your doctor can recommend what is best for you, and lab test will help guide the direction needed to help you stay in control.[4]

You need to pay attention to certain risk factors such as family history. People with a family history of cardiac disease and diabetes are often at a much higher risk.  One parent dying from sudden cardiac risk produces some significance for concern but two parents dying from sudden cardiac arrest can increase your risk to 9.4 according to the Paris Prospective Study.  Smoking also increases risk factors along with obesity, hypertension, high LDL cholesterol, uncontrolled diabetes and stress.  While heredity and race cannot be controlled, they are also risk factors.

It is extremely important to concentrate on the things that you can control through the use of diet and exercise. People in high stress jobs have a tendency to ignore their health, eat poorly and get little exercise because of long hours and commitments. Lifestyle change is paramount if you are going to have a long life. Your health can be deteriorating rapidly with death being the impending warning sign.

I would encourage anyone who is a diabetic to get your diabetes under check and to seek care. Don’t think that an annual visit is all that you need. There are so many bad outcomes associated with poorly controlled diabetes that it is extremely important to get it under control. Find time for yourself and ways to relieve your stress. We all get one life and our health becomes so much more valuable with age.

In memory of Cindy May 27th 1964- April 24th, 2013.

[1] Bergner, Daniel, and Goldberg Jeffrey, Diabetes Mellitus and Sudden Cardiac Death: What are the Data? Cardiology Journal 2010; 17, 2: 117-129

[2] Smith, Jennifer, Pharm. D. Diabetes and Sudden Cardiac Death, Medscape News Today. US Pharmacist. 2013;38(2):38-42.

[3] Ibid Bergner, Daniel

[4] Ibid, Ibid Smith, Jennifer