Coronavirus and your health

Learn more about COVID-19 and diabetes   |   Precautions for patients facing higher risks

Coordinating Your Care, Even When You Need to Stay at Home with the Coronavirus

Your Care Team

For those with (or those supporting loved ones) with diabetes, it’s important to be on the lookout for changes in health status. You don’t have to manage risks and treatment plan alone. Working with your diabetes care team can help you build (and stick with) the best plan for your whole body. And even if the coronavirus is keeping you at home, a “check in” visit with your care team visit might be enough to keep you on track.

Who’s Who in a Diabetes Care Team?

Ready to build your well-rounded care team? Start by knowing that you’re the most important member of your diabetes care team. Take a role in decision making and be sure to let your team know what’s your goals are.

Next, think about each doctor and specialist you currently see. Is there anyone missing who you need to see so you can best manage your symptoms and risks?

Core Team:

  • Primary Care Provider (PCP): Who you typically see for routine medical care, including preventative care for blood pressure and cholesterol, diabetes management, and acute illness.
  • Certified Diabetes Care and Education Specialist (CDCES): Trained to empower diabetes patients to care for their body with effective and proven techniques. Typically provide diabetes self-management education and support (DSMES).
  • Registered Dietitian: A nutrition expert who can help you develop an eating pattern that will support healthy blood glucose, cholesterol, and blood pressure.

Additional Specialist Support:

  • Endocrinologist: Treats conditions of the endocrine system. Endocrinologists specialize in helping patients gain control of diabetes and other hormone-related diseases.
  • Cardiologist: Treats cardiovascular conditions, including those related to or caused by diabetes. They may adjust your medications and plan based on your heart and stroke risk.
  • Registered Dietician: Helps you develop an eating pattern that will support healthy blood glucose, cholesterol, and blood pressure.
  • Optometrist: Can find and treat certain eye conditions and diseases. They can also prescribe glasses and contact lenses.
  • Ophthalmologist: Finds, diagnoses and treats all eye diseases, including severe eye problems. They can also prescribe glasses and contact lenses.
  • Podiatrist: Helps you keep your feet and legs healthy by assessing nerve damage and detecting problems caused by diabetes, such as poor circulation.
  • Pharmacist: Fills your prescriptions, but can also help you with your blood glucose monitoring, offer education, identify drug-related problems, and more.
  • Dentist: Takes care of your teeth with routine care like cleanings which can lower your A1C and reduce your risk of periodontal disease (which is higher for diabetes patients).
  • Mental Health Professional: Can help you deal with the daily challenges and emotional weight of living with diabetes. This could be a psychiatrist, social worker, or therapist.
  • Fitness Professional: Helps you build an exercise routine that is safe for you. This can be an exercise physiologist, personal trainer, or physical therapist. Work with someone who understands diabetes so you can be sure your blood glucose is taken into consideration.

Why a Cardiologist is Important

A cardiologist can assess your cardiovascular risks and help you develop a plan to protect your heart from the long-term effects of diabetes. If you have heart disease and you haven’t looped in a cardiologist yet, ask your PCP for a referral – they probably have someone they work with regularly.

Here are some starter questions to take to your appointment:

  • What are my personal risk factors for cardiovascular disease, such as heart disease or stroke?
  • Which risk factors can I control?
  • What foods should I eat? What should I avoid?
  • Can you review my list of current medications?
  • How often should I have my blood pressure and lipid levels checked?
  • What other levels should I monitor?

If You Need Help: Getting Started

A diabetes self-management education and support (DSMES) services can help you learn how to manage diabetes and address your personal needs if you need help getting started. A certified diabetes care and education specialist (CDCES) can coach you and give you tools to navigate it all and support your treatment plan. Ask your primary care physician for a referral at your next appointment. Many DSMES services now offer telehealth options.  To find a DSMES service near you, check out the DSMES locator. 

When it comes to diabetes, your care team can go a long way toward helping you keep your whole body, including your heart, as healthy as can be. Keep regular appointments with all of your specialists to lower your overall risks of diabetes-related complications.

Learn more and join the Know Diabetes by Heart initiative at knowdiabetesbyheart.org.

For More Information

Teaming Up: How to Play and Active Role in Your Diabetic Care to Minimize Heart Risk

How to Find Diabetes Support

Taking Care of Your Mental Health

Woman in mask meditating in bedroom

Since the COVID-19 crisis arose, life has become more stressful for almost everyone. It’s normal to feel worried. But for people with conditions such as diabetes and heart disease — who face a greater risk from the virus — anxiety might be overwhelming.

Now’s a good time to take a breath, examine some of your habits and see if you can make positive changes.

For example, are you staying up too late or overindulging in your favorite comfort foods? Is it harder to concentrate or make decisions? If so, you’re not alone. Here are some more questions to help you gauge your level of anxiety:

  • Are you overwhelmed with fear about your own health or that of your loved ones?
  • Do you feel more anger, hostility or irritability than usual?
  • Are you deeply upset about how life has changed since the coronavirus appeared?
  • Have you been neglecting routine hygiene and self-care?
  • Are you having headaches, muscle tension, digestive issues or other physical symptoms?
  • Have chronic health problems or mental health conditions worsened?
  • Are you using alcohol, tobacco or other substances more frequently?

If stress interferes with your daily activities for several days in a row, call your health care provider.

Anxiety can make the best-laid plans fall apart. But it’s vital for people with conditions like heart disease and diabetes to stick to their treatment plans and to consult their health care providers if they are struggling.

Meanwhile, there are a number of things you can do to reduce your anxiety about COVID-19. Focus on self-care, including eating well, exercising regularly, getting enough sleep and avoiding alcohol and other substances.

Make a point of limiting how much pandemic-related news and social media content you take in every day. Know when enough is enough! You’re in control. Stop scrolling and pick up a book instead. Here are some more tips:

  • Try meditating, stretching, deep breathing, yoga, mindfulness or other stress-reduction techniques.
  • Indulge in a calming ritual like a hot bath, a nature walk, journaling or quiet time with pets.
  • Set aside time for hobbies, music, movies or other enjoyable pastimes.
  • Agree on a daily schedule for everyone in your household to help reduce day-to-day friction.
  • Find people and things that make you laugh.
  • Establish your own special space where you can quietly relax.
  • Tackle projects on your long-term to-do list, such as cleaning a closet or reorganizing your office.
  • Connect with your usual support network as well as other loved ones, share how you feel and support them as they cope with the pandemic.
  • Find an online support group.

If you’re feeling overwhelmed by anxiety or sadness, contact your primary care provider, your health insurer or your employer’s Employee Assistance Program, if available, to find a mental health provider. (Remember, many appointments are being conducted by phone or video during the pandemic, so you can avoid in-person contact.)

 In an emergency, call:

For More Information

Know Your Numbers, Lower Your Risk

Taking care of yourself and managing your diabetes can be overwhelming and stressful in our current times.  And while many things right now make us feel out of control, there are many things you CAN do to take control of your diabetes and lower your risk of heart disease and stroke. The first step is to know your critical numbers. You’ve got this!

The Numbers You Need to Know

Knowing these five numbers can give you a more accurate picture of your health. And keeping them within the target range can help lower your risk of heart disease and stroke!

At your next appointment (live or via telehealth), talk to your doctor about these measurements so you can build a customized plan together.

What Is It?Target RangeHow is it Done?How Often?
BMI (Body Mass Index) & Waist CircumferenceA body size calculationBMI 18.6-24.9 Waistline: Smaller than 35 inches for women and 40 inches for menEnter height and weight into a BMI calculator Measure around your bare waist, at the belly buttonRegularly at home and at every doctor’s appointment
Blood PressureThe force of blood pumping through your arteries when your heart beatsLess than 120/80 mmHGAt home with an arm cuff and/or at your doctor’s officeDaily at home if possible, and at every doctor’s appointment
A1C(Diabetes)Your average blood glucose levels for the past 2-3 monthsA1C ≤ 7%Blood TestEvery 6 months or more often if needed
CholesterolA waxy substance produced by the liver or from foods derived from animalsTotal: Less than 200 mg/dL LDL (bad): Less than 100 mg/dL HDL (good): More than 40 mg/dL   Triglycerides: less than 150 mg/dLFasting blood testYearly or as recommended by your doctor
Kidney FunctionKidneys filter waste and fluid from the body. There are two kidney tests: Albumin (urine test) and GFR.   GFR tests how well the kidneys are filtering blood.   A urine test checks albumin levels. Albumin is a protein that can pass into the urine when the kidneys are damaged.GFR test GFR >60 is normal GFR < 60 may mean you have kidney disease GFR <= 15 is kidney failure   Albumin test 30 mg/g or less is normal > 30 mg/g may be a sign of kidney diseaseBlood test       Urine testYearly or as recommended by your doctor

You Have the Numbers, Now What?

When it comes to your health plan, following up on your stats and maintaining healthy routines to reduce your risk for heart disease and stroke will put you in better control of your health! You CAN thrive with diabetes, here are a few tips:

To build the best possible treatment plan for YOUR body, and significantly lower your risk of complications it’s important to find out what your numbers are. Following your prescribed lifestyle and medication plan can go a long way in making it happen!

Learn More

Make the most of your medication plan

Learn more about diabetes medications

On how diabetes impacts your kidney and heart health

Get more tips and join the initiative at KnowDiabetesByHeart.org/join.

What is Heart Failure

Man hold chest in gym

Type 2 diabetes and heart failure can be a troubling pair. They can threaten your health, decrease your quality of life and increase your care costs.

But there is good news if you’re dealing with both conditions. Recent studies have found new treatments for diabetes may also improve heart failure outcomes.

Many of the risk factors behind type 2 diabetes and heart failure are similar, yet health care providers are sometimes left scratching their heads over how to care for people with both, according to a scientific statement from the American Heart Association and the Heart Failure Society of America.

People with type 2 diabetes, characterized by elevated blood sugar levels, are two times more likely to develop heart failure than someone without diabetes. But heart failure, a condition in which the heart fails to efficiently pump oxygenated blood through the body, also is a risk factor for diabetes.

Keeping careful tabs on both is vital to getting good care.

If you have heart failure, you might see a cardiologist. If you have diabetes, you may visit your primary care doctor or endocrinologist. Ideally your patient care teams will be aligned and aware of how medications used for one condition affect the outcome of another.

“There’s so much new data coming out all the time. We want to bring attention to the fact that diabetes and heart failure have substantial overlap, and it’s important to stay up to date on new information,” said Dr. Shannon Dunlay, a heart failure cardiologist at the Mayo Clinic in Rochester, Minnesota.

It’s also important to take proactive steps to improve your health, like getting regular exercise, maintaining a healthy weight and eating a well-balanced diet. People with diabetes also need to keep their blood sugar levels under control. Talking to your healthcare provider is key.

It’s important that people with either or both conditions touch base regularly with their doctors, Dunlay said.

“There’s still a lot that we don’t know about how best to manage patients with diabetes and heart failure, but a number of ongoing studies will help to elucidate things further,” she said. “This is an exciting area in medicine and science right now, and we’re going to find a lot of opportunities to improve patient management and outcomes.”

Here are more tips:

How to reduce your risk of heart failure
Millions of people with type 2 diabetes are leading healthy lives. Here are a few tips:

  • Be in the know. Talk to your doctor about how you can manage your risk for heart disease, including heart failure.
  • Get regular check-ups, take your medicine and follow a healthy diet. Keep moving, too! Your lifestyle has a big influence on controlling your diabetes and reducing your risk for heart disease.
  • You do you. Each person with type 2 diabetes has a unique journey. Using tools like medication guides, healthy menu plans and tips for exercising can set you on the right path.
  • Don’t lose hope. It’s an exciting area in medicine and science, and experts predict great opportunities to improve patient management and outcomes.

Talk to your doctor about your next steps and remember that you’re not alone. Find answers to your questions and sign up to receive our monthly newsletter with tips, recipes and more, Know Diabetes by Heart.

Here’s resource to keep with you and keep you motivated – Small Steps to Big Changes: Things You Can Do to Reduce Your Risk for Heart Failure

Managing Diabetes — Even With the Coronavirus Keeping You Home

In these times of the coronavirus, you may feel overwhelmed with managing diabetes. But the Diabetes Self-Management Education and Support (DSMES) program can keep you on track.

DSMES helps you develop a realistic diabetes plan, solve problems and give you confidence to manage your diabetes. It may also help you:

  • Feel empowered.
  • Feel less stressed about diabetes.
  • Reach better A1C levels.
  • Manage blood pressure and cholesterol levels.
  • Eat healthy and engage in more physical activities.
  • Avoid serious health problems in the future.

Many practices offer telehealth diabetes education with recent guidance from the Centers of Medicare and Medicaid. The practices can set up one-on-one visits while you’re at home. The visits are temporarily reimbursed through Medicare, Medicaid and many insurers.

To learn more about how telehealth can help you manage your diabetes, watch the Cardiovascular Care & Telemedicine video.

If telehealth visits aren’t an option from your primary care or endocrinologist office, ADA Recognized National programs can provide virtual diabetes self-management education and support.

Even if you’ve been managing diabetes for some time, the American Diabetes Association recommends annual education to stay on track with your plan. So, ask your doctor for a referral to DSMES.

Find more information on Diabetes Self-Management Education and Support here. You can find a program near you at diabetes.org/findaprogram.

For details on how to prepare for your telehealth visit check out these tips.

What People With Diabetes Need to Know About COVID-19

With new information emerging every day, there’s a lot we still don’t know about COVID-19.

But older adults and people of any age who have serious underlying medical conditions, including diabetes, appear to face a higher risk for severe illness from the virus, according to the Centers for Disease Control and Prevention.

And if you’re living with diabetes and you contract COVID-19, you’re more likely to be hospitalized and need intensive care.

The good news is there’s plenty you can do to stay in control. The most important things are keeping your blood glucose well controlled and minimizing your chances for getting the virus.

Talk to your health care provider about managing your risk and any viral symptoms. If you feel ill — including higher fever with cough and shortness of breath — seek emergency care right away. It’s a good idea to contact the ER to let them know you’re on your way and get any advice. If you have a face mask, put it on before you enter the hospital.

With preparation, you can manage your risk and stay healthy. Watch the COVID-19 & Your Health video.

Stay safe at home. 

You’ve probably heard about the importance of physical distancing (staying at least 6 feet away from others) during the coronavirus outbreak. Take the advice extra seriously if you have diabetes. Never skip an opportunity to thoroughly wash your hands. And self-quarantine if you have been with others who might have the infection.

Here are some more tips:

  • Stock up on the essentials. Make sure you have enough insulin, other medications and supplies (like syringes, ketone testing supplies, rubbing alcohol and hand soap) for a week or more.
  • Know what you can eat in a pinch. Keep simple carbs and electrolyte drinks handy. Stockpile non-perishable health foods.
  • Find a way to de-stress. From puzzles to knitting to genealogy and much more, some people are finding more time for hobbies. Connect with friends and find out what they’re doing to stay active.
  • Stay active for your health. You don’t have to watch every news story or stay glued to social media. Take a solo walk or move more together with the American Heart Association’s virtual workouts.

If you have COVID-19.

If you’ve been diagnosed with COVID-19, do your best to ensure your glucose levels are carefully managed and continue to take your medications as directed. You should consult with your doctor as soon as possible about scenarios that could trigger a change to your diabetes medication plan.

If your symptoms worsen and you need to go to the emergency room, take all your devices (e.g., CGM, insulin pumps) and medications with you. This will ensure you’re prepared and can continue monitoring your glucose levels.

Take advantage of telemedicine.

There’s no better time to take advantage of digital resources and telehealth to help safely manage your care from the comfort of your home.

Telemedicine is fast becoming a convenient way to get care without increasing your chances of exposure to COVID-19. It’s also freeing health care workers and supplies, which is especially important in hard-hit areas.

Many doctors’ offices have guidelines for virtual visits. If you haven’t heard from your health care provider about such options, it doesn’t hurt to call and ask.

If you’re not tech-savvy, don’t worry. Telemedicine technology isn’t complex and it’s available to almost everyone. All you need is a computer with a camera and a microphone, or even a smartphone or regular phone, depending on your doctor’s office.

Don’t hesitate to reach out.

The American Diabetes Association’s free online Support Community and the American Heart Association’s free online Support Network connect people with similar health concerns, including diabetes.

The AHA is funding new research and connecting researchers and doctors with the latest information.

Latest Information on COVID-19

Get the latest American Diabetes Association information and recommendations on COVID-19.

Get the latest American Heart Association information and recommendations on COVID-19.

Centers for Disease Control and Prevention information and resources for COVID-19.

Get Motivated to Get Moving

Man walking his dog

It’s not exactly breaking news: Exercise can lower your blood sugar and blood pressure, boost your energy and help you sleep better. But how do you get started when you’re in a slump?

Most of us (about 80% of Americans) don’t make exercise a regular habit. Maybe you weren’t physically active before your diagnosis, so tackling a new routine seems overwhelming.

If you want to move more but you keep finding excuses, there’s never been a better time to start a fitness habit. Your body is counting on you — and your blood sugar will thank you.

If you’ve made it this far, you’re already on the right track. Check out our recommendations for getting started.

Start small — just spend less time sitting. Consider sneaking in a little light-intensity activity. Park the car farther away at the grocery store. Take the stairs instead of the elevator. Simple steps add up.

Get stretchy. Stretching always comes first. Be sure to warm up for several minutes to get your muscles ready and then stretch slowly for at least 5 minutes before you begin. Learn these basic stretches.

Gradually work up to more activity. The goal is to get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both. That could include activities like brisk walking, water aerobics, swimming or jogging.

Add a muscle-strengthening activity (such as resistance or weights) two days a week, increasing repetitions and intensity gradually over time.

Set your fitness goals. Write ‘em down, tell a friend, join a group on social media — whatever works to help keep you on track.

Don’t work out alone. Seek out like-minded people (virtually or in your own home) and build a new routine. This will help you make progress and keep you motivated and accountable.

Watch your numbers (and take a bow!) Keeping appointments with your health care team is important. Healthier weight, lower blood pressure, more stable blood sugar, better cholesterol numbers and improved muscle tone are all praiseworthy goals.

You also can use the results of your blood sugar checks to see how your body reacts to different activities. Understanding these patterns can help you prevent your blood sugar from going too high or too low.

The American Diabetes Association suggests that you become familiar with how your blood sugar responds to exercise. Checking your blood sugar level more often before and after exercise can help you see the benefits of activity.

Celebrate your fitness success. Whether it’s improved cholesterol or a 5-pound weight loss, reward yourself with something tangible, like an at home dance party, order new active shoes or an at home spa day.

Still convinced that the couch potato life suits you just fine? If you think you hate exercise, check out these pointers. Don’t give up, call a friend. Or better yet — meet for a walk. Who knows? You just might want to do it again tomorrow.

Make the Most of Your Medication Plan

Woman discussing meds with provider

To help you better manage your diabetes and heart health, your doctor may prescribe medication. A solid medication regimen, in combination with a healthy diet and exercise, can help reduce your risk of heart disease and stroke.

How Medication Helps

Your doctor may prescribe a combination of medications to lower your blood glucose and reduce cardiovascular risk. This may be based on your medical history.

They might prescribe medication to:

  • Manage blood glucose
  • Manage high blood pressure
  • Manage high cholesterol
  • Manage your risk for heart and kidney complications
  • Stop blood clots

Your prescription may take the form of a pill, injection, or in the case of regular insulin, a wearable pump.

Sticking to your medication and treatment plan can prevent diabetes from progressing and cardiovascular disease.

A Prescription for Success

It’s easy to feel overwhelmed by your medications at first. Building an effective routine will help you get it all under control.

Here’s how you can make your medications work for you:

  • Keep a list of everything you’re currently taking (including herbs, vitamins and OTC’s) with our medicine chart, so you can review it with your doctor at each appointment.
  • Fill your prescriptions as soon as you get them, and if possible, set them up for automatic refills.
  • Talk to your doctor about the best timing for each of your prescriptions and what to do if you miss a dose.
  • When possible, add medication to routine things you already do each day – like having breakfast, brushing your teeth or going to bed.
  • Divvy up your pill-based meds into a daily medication dispenser.
  • Set calendar reminders (to take your meds or refill them) so you can stay on track.
  • Ask your doctor which meds you can group together based on their efficacy and interactions.
  • Note any side effects or concerns you have and discuss them with your care team, so you can make adjustments and find the best solution.
  • Ask someone you care about to be your accountability buddy. A simple check-in now and then can go a long way!

The Right Plan, The Best Support

If you have diabetes, it’s normal to feel overwhelmed at times. But when it comes to your health, remember that you’re in the driver’s seat. You’re very capable of building a healthier life – and you can make changes today that can have a positive impact on your body and your future. In addition to taking your meds, you are on the way to reducing your cardiovascular (CVD) risk.

Here are some things to consider to get started:

  • At your next appointment, ask your doctor about how to manage your risk for heart disease and stroke.
  • Ask your doctor for a referral to recognized diabetes self-management education and support (DSMES) services (this is often covered by insurance).
  • Keep your blood glucose, cholesterol and blood pressure in target ranges.
  • Eat smart with a healthy, balanced diet.
  • Move more with daily exercise. The goal is 150 active minutes per week.
  • Take your medications as prescribed. Talk to your doctor if you have side effects that impact you.
  • Get your specialists, like the cardiologist and endocrinologist, on the same page.
  • Ask your doctor if your diabetes is affecting your kidney function.
  • Stay positive! Scientists are making exciting new discoveries every day that will lead to a brighter future for patients who have diabetes and/or heart disease.

One of the most important things to keep in mind is that everyone’s health journey is different, especially with type 2 diabetes. You may have some days where it feels like it’s more difficult to manage or some days where it’s easier. But your efforts do make a difference! Ultimately, what matters is making progress toward your goals.

No matter how you get there, it’s important to stick to the plan as prescribed by your doctor. Your daily medication routine can have a big impact on your blood glucose levels, cardiovascular risks and your overall health. Remember, you’re not in this alone. Want regular updates to guide you on how to best manage your heart health? Register at knowdiabetesbyheart.org/join.

Understanding Your Medications

Diabetes, Your Heart and Kidneys: A Triangle of Risk

With type 2 diabetes, your risks for developing heart disease and chronic kidney disease are also elevated. Diabetes is so interconnected to both; recent studies have shown that therapies for diabetes can also improve outcomes for heart and kidney health.

How It’s All Connected

You may not think of your kidneys and heart as a connected system, but they are.

How? Well, your kidneys are powerful filters that remove toxins from your blood through a complex network of arteries, veins, and vessels – which are part of your cardiovascular system.

Type 2 diabetes can put a lot of stress on all these structures – both in your heart and in your kidneys. There’s an overlap between their risks and care. To stay healthy, it’s vital for you and your doctor to keep tabs on both.

But this is good news – with the right care plan, you can help manage your type 2 diabetes and fight heart and kidney disease all at once. What’s good for your heart is also good for your kidneys.

What Are My Risks?

When you manage your diabetes, you also manage your risk of heart and kidney disease. Remember, your diabetes, cardiovascular and kidney risks are all interconnected. Talk to your doctor about reducing your risk.

Research shows that:

  • Approximately 1/3 of people with diabetes develop kidney disease.1
  • Diabetes can damage blood vessels in your kidneys, which can eventually lead to chronic kidney disease.
  • High blood pressure can worsen kidney damage and various cardiovascular risks, like heart attack and stroke.

The Right Plan, The Best Support

If you have diabetes, it’s normal to feel overwhelmed at times. But when it comes to your health, remember that you’re in the driver’s seat. You’re very capable of building a healthier life – and you can make changes today that can have a positive impact on your body and your future.

Try one of these to get started:

  • At your next appointment, ask your doctor if your diabetes is affecting your kidney function.
  • Keep your blood glucose, cholesterol and blood pressure in target ranges.
  • Eat Smart with a healthy, balanced diet.
  • Move More with daily exercise. The goal is 150 active minutes per week.
  • Take your medications as prescribed. Talk to your doctor if you have side effects that impact you.
  • Get your specialists, (like the cardiologist and endocrinologist) on the same page.
  • Stay positive! Scientists are making exciting new discoveries every day that will lead to a brighter future for patients who have diabetes and/or heart disease.

One of the most important things to keep in mind is that everyone’s health journey is different, especially with type 2 diabetes. You may have some days where it feels like it’s more difficult to manage or some days where it’s easier. But your efforts do make a difference! Ultimately, what matters is making progress toward your goals.

If you need an extra boost in the support department, join the Know Diabetes By Heart™ initiative. The American Heart Association and American Diabetes Association have teamed up to bring you the best science-backed tips and tools, resources for people living with type 2 and expert advice on managing all your risks.

Here’s a resource to keep with you and keep you motivated – Heart Health: The link between Type 2 Diabetes and Chronic Kidney Disease.

Source
1. CDC National Chronic Kidney Disease Fact Sheet, 2017. www.cdc.gov/kidneydisease. Accessed September 16, 2019 (from NKF T2D and KD sheet)

How to Find Diabetes Support

Caregiver taking to patient

For diabetes care that will help you thrive, the right meds and habits can go a long way. But a truly holistic plan doesn’t stop there – it also includes a strong support system. You may be doing great on your own for some things, but everyone struggles in some areas. Maybe you’re overwhelmed by all the information, or maybe you’re nervous about the future. It can often be stressful to manage everything.

We all need a little help and encouragement sometimes. With a support system to cheer you on, you’ll get the boosts you need to stay motivated and positive.

Build your network

For support, you can look to people you know and trust or even expand your circles to include new friends. Everyone needs a shoulder to lean on and you might be surprised by how many people are willing to help. Some people who might be good partners on your journey:

  • Family or friends who can make lifestyle changes with you.
  • Friends or family who you can talk to, walk with and depend on when the going gets tough.
  • A therapist who specializes in coping with health concerns or patient empowerment.
  • Your doctor, or a specialist like a dietician or endocrinologist.
  • A coach from a Diabetes Self-Management Education and Support service. Ask your doctor for a referral, sessions may be covered by insurance.
  • Diabetes support communities are available for you at supportnetwork.heart.org or community.diabetes.org.

HEALTHY LIFESTYLE GOALS

Some ways to build a healthy lifestyle with diabetes:

  • Stay on top of your medications, appointments any other parts of your doctor-prescribed health plan.
  • Eat smart with a diet full of fruits and vegetables, whole grains, lean protein and healthy fats.
  • Move more with consistent daily exercise, aim for about 20-25 minutes per day.
  • Keep a positive attitude – strive to have a healthy body with diabetes and make changes that can help get you there.
  • Talk with others experiencing type 2 diabetes. You’re not alone and many people experience the same struggles and difficulties.

With your support network in mind, start with just one area that you’d like to improve. The others will soon follow. Rallying support can help you stay focused so you can make it happen. Find answers to your questions and sign up to receive our monthly email with science-backed tips, recipes and more at: knowdiabetesbyheart.org/join.

Diabetes and heart failure can be a troubling pair

Diabetes and heart failure can be a troubling pair – yet new treatments may provide positive outcomes

Type 2 diabetes and heart failure can be a troubling pair. They can threaten your health, decrease your quality of life and increase your care costs. But there is good news if you’re dealing with both conditions. Recent studies have found new treatments for diabetes may also improve heart failure outcomes.

Many of the risk factors behind type 2 diabetes and heart failure are similar, yet health care providers are sometimes left scratching their heads over how to care for people with both, according to a scientific statement from the American Heart Association and the Heart Failure Society of America.

People with type 2 diabetes, characterized by elevated blood sugar levels, are two times more likely to develop heart failure than someone without diabetes. But heart failure, a condition in which the heart fails to efficiently pump oxygenated blood through the body, also is a risk factor for diabetes.
Keeping careful tabs on both is vital to getting good care.

If you have heart failure, you might see a cardiologist. If you have diabetes, you may visit your primary care doctor or endocrinologist. Ideally your patient care teams will be aligned and aware of how medications used for one condition affect the outcome of another.

“There’s so much new data coming out all the time. We want to bring attention to the fact that diabetes and heart failure have substantial overlap, and it’s important to stay up to date on new information,” said Dr. Shannon Dunlay, a heart failure cardiologist at the Mayo Clinic in Rochester, Minnesota.

It’s also important to take proactive steps to improve your health, like getting regular exercise, maintaining a healthy weight and eating a well-balanced diet. People with diabetes also need to keep their blood sugar levels under control. Talking to your healthcare provider is key.

It’s important that people with either or both conditions touch base regularly with their doctors, Dunlay said.
“There’s still a lot that we don’t know about how best to manage patients with diabetes and heart failure, but a number of ongoing studies will help to elucidate things further,” she said. “This is an exciting area in medicine and science right now, and we’re going to find a lot of opportunities to improve patient management and outcomes.”

Here are more tips:

How to reduce your risk of heart failure

Millions of people with type 2 diabetes are leading healthy lives. Here are a few tips:
Be in the know. Talk to your doctor about how you can manage your risk for heart disease, including heart failure.

  • Get regular check-ups, take your medicine and follow a healthy diet. Keep moving, too! Your lifestyle has a big influence on controlling your diabetes and reducing your risk for heart disease.
  • You do you. Each person with type 2 diabetes has a unique journey. Using tools like medication guides, healthy menu plans and tips for exercising can set you on the right path.
  • Don’t lose hope. It’s an exciting area in medicine and science, and experts predict great opportunities to improve patient management and outcomes.

Talk to your doctor about your next steps and remember that you’re not alone. Talk to your doctor about your next steps and remember that you’re not alone. Find answers to your questions and sign up to receive our monthly newsletter with tips, recipes and more.

Prioritizing your mental health while managing diabetes and heart disease

Mature African-American women exercising

Chronic health conditions such as heart disease and diabetes take more than just a physical toll.

Keeping up with doctor appointments, health numbers—glucose numbers, blood pressure numbers, weight and others—and making multiple decisions per day about meals and medications bring a unique mental burden for people who are managing both diabetes and heart disease.

Feeling overwhelmed “is not something that represents any kind of a failing,” said Jeffrey Gonzalez, professor of psychology at Yeshiva University and professor of medicine, epidemiology and population health at Albert Einstein College of Medicine. “It’s normal to be stressed about it and it’s not something that you have to hold back from health care providers. It comes with the territory.”

Gonzalez recommended that patients talk with their health care team about their feelings.

And, if appropriate, address signs of depression. Gonzalez noted that it can negatively impact quality of life and the ability to work, be productive and enjoy time with friends and family.

Kelly Close, founder of The diaTribe Foundation, a nonprofit diabetes advocacy organization, said that diabetes and heart disease can impact mental well-being even in people who aren’t clinically depressed.

Close said new medical advances, such as continuous glucose monitoring, can help some people manage the myriad daily decisions someone must make when living with diabetes. The wearable devices provide feedback about how meals, exercise and medication impact blood glucose (also called blood sugar) on a continuous basis. “We like thinking about what we can do in managing diabetes,” Close said.

Other things you can do, she says, are getting enough sleep, increasing physical activity and eating an appropriate diet.

Tips for managing type 2 diabetes-related stress

Movement: For mind and body

While aerobic exercise that gets the heart pumping appears to produce the most endorphins, the hormone associated with the so-called runner’s high, even light-intensity exercise is associated with well-being. Those activities might include taking a walk around the block, using the stairs instead of the elevator or gardening.

Eating for whole body wellness

Observational studies suggest that eating fruits, vegetables, whole grains and lean protein sources such as fish appears to be associated with a reduced risk of depression as compared to diets high in processed foods and sugar. Lean proteins are part of a heart-healthy diet as well, so this is a win-win for your overall health.

Sleep

There are mental and emotional benefits of getting good sleep. Sleep deprivation is linked to negative mood and irritability. A stable mood is helpful when you’re making health decisions.

In addition to the mental health benefits of better sleep research has shown that people with high blood pressure, type 2 diabetes, heart disease or stroke could have additional health problems if they sleep less than six hours per night.

Support

Both the American Heart Association and the American Diabetes Association offer online support groups and communities. Research shows that people with social support tend to stick with healthy lifestyle habits more so than those without such support.

Culture and care in managing diabetes and heart health

Group of friends laughing

As CEO of DiabetesSisters, a nonprofit that supports women with diabetes or are have prediabetes, Anna Norton hears a certain concern regularly: “Yes, I have diabetes, but I don’t want to lose my culture.”

Norton understands—the Cuban-American was diagnosed with type 1 diabetes when she was 18.

“For many cultures, our experiences are surrounded by food,” Norton said. “We have a lot of memories of food. First and foremost, we should never have to give that up because we have diabetes.”

Considering that heart disease and stroke are the most common complications of diabetes, an eating plan is an even more important part of managing diabetes.

As part of its minority initiative, DiabetesSisters sponsors outreach events for various ethnic groups throughout the country. For example, one in the Washington, D.C., area focuses on African American food and culture. In New Jersey, it’s geared toward women from Southeast Asia. In Miami, presentations are in Spanish.

The groups are very sensitive to food and culture. “What does a Dominican plate look like for people with diabetes? What does a Puerto Rican plate look like?”

Juanita Cano of Dallas doesn’t have diabetes. But “everyone in my family does,” she said. As a Champion in the American Heart Association and American Diabetes Association’s Know Diabetes by Heart™ initiative, she eats healthy to prevent diabetes—and to avoid heart disease.

That means “letting go of pan dulce, arroz con leche and other desserts,” Cano said. It’s been tough, she said, but she’s found balance by focusing on lean-meat for fajitas and carne asada, and chicken or fish cooked in small amounts of olive oil or grilled. She flavors food with chimichurri, a sauce with vinegar, olive oil, parsley and other herbs and spices, as well as fresh tomato salsa.

“You don’t have to give up Mexican food completely,” Cano said. “But just learning how to make substitutions and better choices can improve your health tremendously.”

“People do need to adjust what they eat,” Norton said. “We’ve been able to drive that home, and at our events, women walk out feeling empowered about what they can have, not what they can’t.”

Hyvelle Ferguson Davis, a Know Diabetes by Heart Ambassador, was diagnosed with gestational diabetes while pregnant with her son. During her pregnancy, she was diligent about eating right. But after he was born, she went back to foods she’d grown up eating: “Chicken wings, red velvet cake, fried chicken, barbecue ribs. There was nothing I wasn’t eating,” she said.

But after having a stroke and heart surgery, she began making exchanges: Almond milk for whole milk. Chicken for beef. Whole-wheat bread for white. Water for sodas.

“That was hard in the beginning,” she said, “but I have gotten better with time.”

In the 26 years since her diagnosis, Norton has learned that she can “eat anything I want,” she said. “I just need to be moderate.” Here are some more of her culture-friendly tips for dealing with a diabetes diagnosis:

  • Find a health care team that understands the importance of culture.
  • Seek others in similar situations. “People who want to help each other are the best link for diabetes,” she said.
  • Understand your alternatives. When you know the right substitutes – like using whole wheat flour in recipes and knowing which spices can bring the tastes of home to your menu – you’ll find the flavors you know and love can be a part of your healthy lifestyle.

Teaming up: How to play an active role in your health care if you have diabetes to minimize your heart risk

Doctor smiling with young couple

Playing an active role in your own health care is important for anyone. For people with diabetes, it’s imperative.

“Diabetes is more complicated than most chronic diseases,” says Robert Eckel, M.D., president-elect of the American Diabetes Association and professor emeritus at the University of Colorado Anschutz Medical Campus. He is also a past-president of the American Heart Association.

“Because of their diabetes, we also have to wonder: Does the patient have heart disease? Do we need to do more tests?”

This is especially important, he said, because the risk of people with diabetes developing cardiovascular disease is two times higher than for those without the disease. In almost a half-century as an endocrinologist, those patients with both diabetes and cardiovascular disease have been Eckel’s focus.

As someone who was diagnosed with type 1 diabetes when he was 5 years old, Eckel’s compassion runs deep. He knows firsthand that dealing with the disease can be overwhelming, especially if patients feel like they’re not a part of the decision making when it comes to their diabetes care team.

“We want patients to leave an office visit with an understanding of the disease and what steps we’re going to take with lifestyle and medications,” Eckel said. Eckel uses what he calls a “three-minute lifestyle intervention.”

  • How many servings of fruits and vegetables do you have a day?
  • How many times a week do you eat fish?
  • What’s your activity platform?
  • How much exercise do you get?
  • What are your barriers?
  • Do you read nutrition labels?”

As active participants in their own care, patients should be able to answer those questions. And, he encourages patients to ask questions freely.

“It is critical to ask questions,” said Jacqueline Alikhaani, a Know Diabetes by Heart Ambassador. Know Diabetes by Heart is a collaboration between the American Heart Association and American Diabetes Association aimed at reducing cardiovascular risk among people with type 2 diabetes. “There are no stupid questions about what you need to know.”

Alikhaani has a congenital heart disease and was diagnosed with type 2 diabetes almost three years ago. She stresses the importance of patients being an integral part of their health care team—especially because diabetes is a 24/7 disease and managing it takes work.

“You really have to be proactive. You are the CEO of your health care,” Alikhaani said.

She and Eckel offer these suggestions:

Prepare for your visit. Ask questions. Write them down ahead of time if you need to.

Be honest. Have candid conversations about your daily habits and lifestyle. This will help you work with your healthcare team to implement changes that are realistic for you.

Take notes. Make note of consistent symptoms, questions about your medications, and any changes in your lifestyle. These can be helpful for your next check-up. Also, take notes during your clinic visits. This can help you remember things, particularly if there are changes in your care plan.