Diabetes and Heart Health

People with diabetes are more likely to develop heart disease or have a stroke than people without diabetes, and they are more likely to develop these problems at a younger age.

This is due, at least in part, to the fact that high blood glucose (blood sugar) levels can damage blood vessels as well as the nerves that control the heart and blood vessels. Additionally, people with diabetes often have a number of other risk factors that increase the chances of developing heart disease. These risk factors include being overweight (especially if the excess fat is found around the waist), high blood pressure, high cholesterol, being inactive, and smoking or using other tobacco products. Having a family history of heart disease or stroke also increases the risk. Because there is nothing we can do about our family history, it is even more important to take actions to minimize those risk factors that we can control.

Reducing your risk

Fortunately, you can reduce your risk of developing heart disease or having a stroke by taking steps to manage your blood glucose, monitoring your health, and making wise lifestyle choices. Here are some guidelines that will help.

• Alcohol intake: If you consume alcohol, check with your doctor to make sure it is all right for you to do so. Alcohol raises blood pressure by interfering with blood flow to and from the heart, and it can affect blood glucose levels. If your doctor says it is okay for you to drink alcohol, do so in moderation.

• Blood glucose: Aim for an A1C level of 7% or less by following your diabetes management plan.

• Blood pressure: Test your blood pressure regularly to make sure it is within the range your healthcare team has established for you, and have it professionally checked every time you visit your healthcare provider.

• Cholesterol: LDL cholesterol (sometimes called “bad” cholesterol) increases the risk of heart problems. Aim to keep yours below 2.0 mmol/L. To limit your LDL cholesterol and raise your HDL (“good”) cholesterol, limit the amount of animal fats you consume and eat more plant-based foods. Triglycerides, another type of blood fat related to cholesterol, can also raise heart disease risk. Check with your healthcare team to find out what range your triglycerides should be in and have your triglyceride levels checked periodically to make sure they are in that range.

• Smoking: The nicotine in tobacco causes blood vessels to narrow, which raises blood pressure. Smoking also makes blood pressure medications less effective. If you are a smoker and need help quitting, your London Drugs pharmacists can help with tips and smoking cessation products that can help you quit successfully.

• Stress: Stress can affect both blood pressure and blood glucose. Learn to manage stress in a healthy manner. Some options include socializing, being physically active, listening to soothing music, and engaging in a hobby you enjoy. Practicing relaxation techniques for just a few minutes each day can also help you manage your stress in a healthy manner.

Helpful relaxation techniques include:

• Yoga and tai chi are ancient arts that combine rhythmic breathing with postures or flowing movements. They provide a mental focus that is calming and can distract you from distressing thoughts.

• Mindful meditation involves sitting comfortably and focusing your attention on your breathing and on the present moment. Don’t let your mind drift to another time or place or to things you are concerned about. Research shows that mindful meditation may be helpful in relieving anxiety, depression, and pain.

• Guided imagery involves calling to mind images of places or experiences that you find soothing to help you relax.

• Breath focus is a simple technique in which you focus on taking long, slow, deep breaths and try to distance your mind from distracting thoughts.

• Body scan combines progressive muscle relaxation with breath focus. After a few minutes of deep breathing, focus your mind on one part of your body or one muscle group at a time and mentally release any physical tension you feel there. When the tension in that spot eases, shift your focus to another part of your body, moving your attention methodically until you have relaxed your entire body.

• Weight: Being overweight can make it more difficult to manage diabetes and can raise the risk for many health problems including high blood pressure and heart disease. A healthy eating plan and more physical activity often help. Excess fat carried around the waist can raise the risk of heart disease even in people who are not overweight. Ask your healthcare team to assess your waist circumference to see if your belly fat is in the healthy range.

When lifestyle changes aren’t enough to reduce your risk, your doctor may prescribe medication. It is important to take the medicine exactly as prescribed in order to get the most benefit from it. If you have any questions about your medicines or how to take them, your London Drugs pharmacists will be happy to answer them. Learn more about the Diabetes Management Clinics offered at London Drugs.

Managing your heart health

Coronary artery disease is the most common form of heart disease for people living with diabetes. This is caused by a buildup of plaque, or cholesterol deposits in the coronary artery walls. These arteries serve to supply oxygen and blood to the heart. When the plaque narrows or blocks the arteries, it decreases the blood flow to the heart, which can then cause a heart attack. If the blood flow to the brain is decreased, a stroke can occur. 1

Adults with diabetes are nearly twice as likely to have heart disease or stroke as adults without diabetes. 2 Gradually, high blood sugar can cause damage to your blood vessels and nerves. When your blood vessels are weak, they can become leaky and susceptible to cholesterol buildup. 3 However, you can make changes today to lower your risk of a heart attack or stroke by knowing you ABCDEsss 4*.

A – A1C of 7.0% or less
This lab test is done every 3 to 6 months measures your blood sugar control.

B – Blood pressure (BP) of less than 130/80 mmHg
Systolic is your top number. Diastolic is your bottom number.

C – Cholesterol (LDL cholesterol) less than 2.0 mmol/L
Buildup of LDL (low-density lipoprotein) and low HDL (high-density lipoprotein) increases the risk of heart attack and stroke.

Drugs
Speak to your health care team about medication to lower your risk of a heart attack or stroke.

Exercise and healthy eating.
See below for some tips.

Self-management support
People with diabetes should set personalized goals to manage their diabetes.

Screening for diabetes complications
Most people with diabetes will need a yearly foot exam, kidney evaluation and an eye exam.

Smoking increases your risk of heart attack and stroke
If you smoke, you should quit.

How to reduce your risk of a heart attack and stroke*

Maintain a healthy plate. 6

• Cook at home. Try to limit highly processed food and restaurant food that are high in salt, fat, and sugar. 7

• Read food labels. Look for foods with a % daily value (%DV) of less than 5% for fat, sodium, sugars. 8

• Make a grocery list. This helps to prevent impulse buys, helps you stay on budget and reduces food waste. 9

Exercise: Keeping active helps your diabetes and your heart

Experts recommend that keeping active can have major benefits for your diabetes, heart, and your weight. It is recommended that you should try to get 5*:

• 150 minutes of aerobic exercise per week. Aerobic is exercise that makes you breathe faster and raises your heart rate. e.g. brisk walking, swimming, dancing, and riding a bike.

• Lifting weights 2 to 3 times per week.

Symptoms of heart disease. 10

The symptoms of heart disease may differ between men and women. Signs may include:

• Chest pain, including a burning sensation, heaviness or pressure/discomfort in the chest

• Upper body discomfort in your arms, neck, shoulders, back or jaw

• Shortness of breath

• Lightheadedness/fainting

• Sweating

• Nausea

If you experience any of these symptoms, immediately call 911 or your local emergency number.

TM see www.ascensiadiabetes.ca/tm-mc. All other trademarks are the property of their respective owners © 2021 Ascensia Diabetes Care Canada Inc.
* Patient should consult with their health care provider about taking medications and prior to making any changes to treatment regimen. 1. Centers for Disease Control and Prevention (2021). Diabetes and Your Heart. https://www.cdc.gov/diabetges/library/features/diabetes-and-heart.html. 2. National Institute of Diabetes and Digestive and Kidney Diseases (2020 NIDDK). Diabetes, Heart Disease, and Stroke. https://www.niddk.nih.gov/health-information/diabetes/overview/preventingproblems/heart-disease-stroke. 3. Heart and Stroke Foundation. Diabetes and heart disease: your top 3 questions answered. https://www.heartandstroke.ca/articles/diabetes-and-heart-disease-your-top-3-questions-answered. 4. Diabetes Canada (2020 Canadian Diabetes Association). Staying healthy with diabetes. https://www.diabetes.ca/DiabetesCanadaWebsite/media/Managing-My-Diabetes/Tools%20and%20Resources/staying-healthy-with-diabetes.pdf?ext=.pdf. 5. Diabetes Canada (2020 Canadian Diabetes Association). Physical activity and diabetes. http://guidelines.diabetes.ca/docs/patient-resources/physical-activityand-diabetes.pdf. 6. Canada’s Food Guide (2019 Government of Canada). Food guide snapshot. https://food-guide.canada.ca/en/food-guide-snapshot. 7. Canada’s Food Guide (2019 Government of Canada). Cook more often. https://food-guide.canada.ca/en/healthy-eating-recommendations/cook-more-often. 8. Canada’s Food Guide (2019 Government of Canada). Use food labels. https://food-guide.canada.ca/en/healthy-eatingrecommendations/using-food-labels. 9. Canada’s Food Guide (2019 Government of Canada). Meal planning. https://food-guide.canada.ca/en/tips-for-healthy-eating/meal-planning. 10. Heart and Stroke Foundation. Emergency Signs. https://www.heartandstroke.ca/heart-disease/emergency-signs.

Health Tips Video: Prevention is Key with Heart Disease

Heart disease is the second leading cause of death in Canada. Visit our healthy heart clinics

Heart disease is the second leading cause of death for Canadians (after cancer). Heart disease is actually a class of diseases that involve the structure and functions of the heart, including conditions like angina, arrhythmia, stroke, heart attack, and more.

Prevention of Heart Disease is Key

According to Sam Ma, a registered pharmacist with London Drugs, “Prevention is really key. Often there are no symptoms of heart problems until the underlying disease has progressed.” That’s really scary when you consider that 90% of Canadians have at least one risk factor for heart disease.

This means that routine screening is really important, and especially important if you’re a woman. The classic symptoms of heart disease don’t always appear in women. Women’s heart disease tends to manifest as chest discomfort, shortness of breath, stomach upset like indigestion or nausea, fatigue, and back or neck pain rather than the crushing chest pain men might experience. Because women’s heart disease can be harder to spot, women are also less likely to be prescribed the drugs they need to lower their blood pressure or cholesterol.

Check out a London Drugs Healthy Heart Clinic

So how can you get screened? London Drugs’ Healthy Heart Clinics are a great option. These are 45-minute one-on-one consultations with a Patient Care Pharmacist to discuss your heart health and look at your risk profile. This includes your lifestyle, family history, and risk factors like blood pressure and cholesterol. Hypertension, or high blood pressure, is one of the main risk factors for heart disease and it’s estimated that 6 million adults in Canada suffer from high blood pressure.

During this screening, the pharmacist will measure your blood pressure and test your cholesterol and blood sugar via a pin-prick blood sample. You’ll also have a conversation about lifestyle changes you can make to reduce your risk of heart disease, such as:

  • Changing your diet
  • Increasing your fitness routine
  • Quitting smoking
  • Cutting back on alcohol consumption

Your pharmacist can also call your family doctor with the results of the screening and recommend potential changes to your medication that could improve your heart health, if necessary.

You can book an appointment online at LondonDrugs.com/healthyheart, or by calling your local London Drugs. Be sure to bring along all your prescription medications, over-the-counter medications, and any herbal remedies you take to help give your pharmacist a comprehensive view of your medication routine.

Book your Healthy Heart appointment by visiting LondonDrugs.com/healthyheart and read more on heart health here.

Pharmacy Awareness Month: Pharmacists are Medication Experts and So Much More

Pharmacy Awareness Month London Drugs Hearth Health Clinics

As the most accessible health care providers in Canada, pharmacists collaborate with patients, their families and other health care providers to deliver a range of innovative services.

During Pharmacy Awareness Month this March, London Drugs pharmacists are reminding patients of the expanded role they play in health care and are encouraging Canadians to take advantage of the valuable health services offered conveniently at London Drugs pharmacies.

LD Pharmacist Leah Sarich on BT Calgary 

BT Calgary London Drugs Pharmacist Leah Sarich

London Drugs Pharmacist, Agusia McGrath, sat down with Breakfast Television Calgary’s Health Specialist, Leah Sarich, to talk about the range of wellness services pharmacists can provide. To watch, just click here.

Services offered at London Drugs pharmacies include:

Discover more about the services at your local London Drugs pharmacy by talking to a pharmacist in-store, or reading more information online.

What’s Your Risk of Heart Disease? London Drugs Now Offering Critical Screening Tests

The statistics are staggering: heart disease is the second leading cause of death in Canada[1], and the leading cause of premature death among women[2]. Otherwise known as the ‘silent killer’, heart disease often has no symptoms, until the underlying disease has progressed. When signs are present, they are easily missed or dismissed.

Heart Health Clinics London Drugs

As one of the most accessible health care providers available to Canadians, our pharmacists are stepping up their efforts to help in the prevention of heart disease by providing critical screening tests conveniently in the pharmacy.

The benefits of screening tests

London Drugs Pharmacist Agusha McGrath recently visited Breakfast Television in Calgary to explain how the screening tests work, and how you can recognize the early signs of heart disease. Click here to watch.

Pharmacists like Agusha now play a key role in the prevention of heart attacks and other cardiovascular problems: helping patients understand their risk factors, emphasizing the importance of medication adherence and offering counselling to make important lifestyle changes.

Sit down with a London Drugs Pharmacist

To help you take control of your own heart health and learn about heart disease prevention, our pharmacists are offering Healthy Heart Clinics, running now until April 26th at 68 London Drugs locations.

During the one-on-one 45 minute Healthy Heart clinics, patients will have the opportunity to sit down with a London Drugs Patient Care Pharmacist for a customized screening and evaluation. The pharmacist screens for total cholesterol, HDL cholesterol, random glucose and blood pressure, and can determine a 10-year cardiovascular risk factor based on those measurements.

They also discuss with the patient how to lower their risk and improve heart health, which includes recommendations for changes to diet, fitness routines or lifestyle. As a collaborative health care provider, the pharmacist may also contact a physician, in order to recommend changes to the patient’s medications, or further medical intervention.

To book a Healthy Heart Clinic appointment visit: http://www.londondrugs.com/healthyheart

[1] Public Health Agency of Canada
[2] Heart and Stroke Foundation of Canada, 2018 Heart Report

Dr Art Hister – Yet another reason to eat your veggies

The good news is that you can lower your risk of stroke.

The bad news, at least for some of you, is that you have to eat your veggies.

A study (published in the journal Stroke: Journal of the American Medical Association) involving over 30,000 Swedish women, some of whom had pre-existing cardiovascular disease, found that those who ate the best diet in terms of anti-oxidant intake had a significantly lower risk of stroke than women who ate a poorer diet, which is no surprise, of course.

But what is a bit of a surprise is that the women eating an anti-oxidant-rich diet had a lower risk of stroke even if they had a history of heart disease.

In other words, and this should be no surprise, the people who likely gain the most from starting to follow a healthy health practice, which in this case is to eat your veggies, are also likely to gain the most from making that change.

Which doesn’t mean, of course, that those of us who are already doing the right things don’t have to emphasize doing them as much – it’s just that we start from a better place in that dash to live longer and healthier, so we don’t have nearly as much to gain from improving what we are already doing.

The Facts About Cholesterol

Cholesterol is an important substance in our bodies that, for the most part, occurs naturally. It helps our bodies make hormones, process vitamin D, build cells and create substances that help us digest food. Cholesterol can become dangerous, though, when the levels in our blood stream get too high.
Most of the cholesterol in our bodies—about 80%—is made by our liver. The other 20% comes from the foods we eat. A person can’t tell if his or her cholesterol levels are too high, as there aren’t any noticeable symptoms. To determine your cholesterol levels you need to have a blood test done by your doctor involving a tiny sample of blood.
The test will analyze the two main components of cholesterol—low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL is sometimes referred to as “bad” cholesterol, because at high levels it builds up and can block our arteries, preventing blood moving freely through our bodies. HDL is usually called “good” cholesterol, because its job is to carry excess cholesterol from other parts of our bodies, including the arteries, back to the liver. Not only does the liver produce cholesterol, it also removes it from our bodies.
Your doctor may also assess your triglyceride and C-reactive protein levels. These are other indicators found in your blood test that could signal an increased risk of heart attack or stroke.

Lowering Cholesterol

The first step is to make a lifestyle change, and a big part of lifestyle is eating a healthier diet. Here are some things you should reduce or avoid to maintain healthy cholesterol levels:
  • Saturated fats—These are found in animal-based foods such as meat and dairy products, and in some plant foods such as coconut oil, palm oil, and cocoa butter. Avoid or limit deli meats. Choose lean cuts of meat, or replace with fish and legumes (lentils, beans) instead.
  • Trans fats—These are a form of man-made fat that is created during a process called hydrogenation. This is where liquid oils are turned into solid fat (such as some margarines.) While technically unsaturated, these facts act like saturated fats and raise blood levels of LDL (“bad”) cholesterol. Choose oils high in mono-and polyunsaturated fats such as canola, corn, or soya oil. Use in moderation.
  • Avoid dairy products with high milk fat—choose 1% MF (milk fat) or cheeses with 15% MF or lower.
There are things you can add to or change in your diet which help the body eliminate excess blood cholesterol.
  • Soluble fibre—This is found in oat bran, fruits, and vegetables.
  • Unsaturated fats—These are found in vegetable oils, nuts, seeds, and fatty fish.
  • Cooking—More often than not, opt to broil, bake, poach, or even microwave food instead of frying.
Image from www.brainshinobi.blogspot.com

Other tips to beat “bad” cholesterol

Keeping active and maintaining a healthy body weight will also help reduce cholesterol levels. And finally, quit smoking. It’s been found that tobacco reduces your level of HDL, “good” cholesterol, and raises your total blood cholesterol levels—which makes the perfect combination for increasing your total risk of having a heart attack.
If your doctor feels you need to be on cholesterol-lowering medication, it’s important to take it exactly as directed. For more information on cholesterol, or advice on making different lifestyle choices, come by the pharmacy and ask your London Drugs pharmacist.
————————————————————————————————–
This article is based on the patient information pamphlet and “My Cholesterol Journal”, available at your London Drugs pharmacy.

Dr Art Hister – Food to Lower LDL

First, the very, very good news: a study has shown that a combination of foods – not just single good-guy foods such as fish or veggies but the whole shebang put together – can significantly lower the risk of bad health consequences in individuals who eat that combo, and in only a short period of time, which may be even better news.

Thus, in this small study of 44 overweight people from Lund University in Sweden, the individuals who ate the way they were told to eat lowered their LDL levels (that’s the “bad” cholesterol) by a staggering 33 % through diet alone (in most diets the maximum LDL-lowering effect is usually about 15-20 %), their total cholesterol levels fell by 14 %, and they also experienced significantly improved levels of other important metabolic factors such as clotting proteins.

So what’s the bad news, you wonder.

Just this: the foods they were given to eat which were very rich in the usual good-guy elements (anti-oxidants, fish oils, probiotics, fibre etc.) and which included good stuff like blueberries and veggies also included heavy doses of barley, soy protein, oily fish (which in Sweden must surely have been herring and the like) and vinegar.

I think if it were me, I’d settle for less of a drop in LDL if it also meant less of an intake of tofu, barley, and herring.

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