by Dr. Barry Tedder and Lisa Tedder
For over 20 years I have tried to figure out the best way to treat and prevent the ravages of cardiovascular disease. Cardiovascular disease is still the leading cause of death in the U.S. and affects not only the heart, but all the arteries of the body, leading to devastating heart attacks, strokes, and limb amputations. The most common known causes or risk factors for cardiovascular disease are: genetics or family history, high blood pressure, high cholesterol, smoking, aging, lack of exercise, obesity and diabetes.
Of these, diabetes and obesity are probably the main causes of cardiovascular disease as 82% of people with heart attacks have either diabetes or insulin resistance. In 2012, approximately 29 million Americans suffered from diabetes and another 86 million were pre-diabetic. Unfortunately, 27% of the diabetics and nearly 90% of the pre-diabetics don’t even realize they have a problem. As a physician, I hope to change those numbers through education and helping people to understand the warning signs.
We need to start treating a patient while they still have pre-diabetes but usually the physician doesn’t see the patient until their blood sugar is sky high and they have full blown diabetes. It is helpful to understand what happens to the body during pre-diabetes. When we eat, the body converts the food into glucose or sugar. The pancreas produces the hormone insulin which then helps the body use the glucose for energy while lowering the glucose or sugar level in the blood. Insulin also stimulates the liver and muscle tissue to store any excess glucose. When we are healthy, our insulin and glucose stays in the normal range.
Scientists believe that excess weight, especially around the waist, and being physically inactive leads to a condition called insulin resistance. This is a condition where the body produces insulin but it doesn’t work correctly. Glucose builds up in the blood instead of being absorbed by the cells. The pancreas then makes even more insulin to help the body absorb the glucose properly. Insulin resistance leads to pre-diabetes or eventually to type 2 diabetes as the pancreas fails to keep up with the need for more and more insulin. By the time you are diagnosed as diabetic, you have already lost 80% of your pancreas’ function.
We now know that fat cells don’t just store excess sugar but they also produce harmful chemicals and hormones which cause inflammation in the body. As someone becomes more obese, the fat cells become chronically overloaded and get larger, making the whole situation worse. The inflammation triggers the body’s immune system, causing damage to the blood vessels. If you have additional health problems such as high cholesterol, high blood pressure, sleep apnea or you smoke, you are setting yourself up for having a heart attack, stroke or needing a limb amputated.
Early diagnosis of pre-diabetes and treatment is the best way to slow down the disease progression before the pancreas wears out. There are no symptoms but those with high triglycerides and excessive abdominal fat are likely to be pre-diabetic. Other blood tests can help confirm the diagnosis. Exercise is important to prevent weight gain or to help you lose weight. It is also important to eliminate starchy carbohydrates like sugar, breads, pasta, cereals, white rice and sodas that are digested quickly and cause blood sugar to rise dramatically, triggering an equally dramatic rise in insulin. Sometimes diet and exercise are not enough and medications like Actos or Metformin are needed.
The focus of cardiovascular disease prevention has been to lower cholesterol with statins and other drugs. While this treatment is very important and the backbone of any preventive plan, it only reduces the risk for a heart attack by about 30%. The best way to prevent heart attacks, strokes and loss of limbs is to diagnose and treat pre-diabetes and diabetes early before the pancreas is worn out.
Key things you can do to be healthier and avoid diabetes and cardiovascular disease.
- Exercising regularly is the single most important thing you can do for your health.
- Know your family history.
- Eat lean meat, not processed or fatty meats.
- Eat plenty of vegetables and fruits that aren’t fried or have added sugar.
- Avoid white breads, pastas, cereals, cookies, cakes, sodas and other sugary treats.
- Stop smoking.
- Take your cholesterol and other medications as prescribed by your doctor.
- Know your blood pressure and cholesterol numbers
Dr. Barry Tedder is a cardiologist with St. Bernards Heart & Vascular. He received his medical degree from the University of Mississippi and the completed his residency at the University of Arkansas for Medical Sciences. Dr. Tedder has many cardiology certifications and is a Fellow in the American College of Cardiology. Lisa Tedder has a blog titled “The Cardiologist Wife”. The two of them have two children.