Diabetes and Heart disease. Sounds like a stupid question, right? One is the domain of a cardiologist and the other an endocrinologist.
Sure, the two are linked and having diabetes greatly increases your risk of having a heart attack. To be a little more precise, 65% of diabetics die of heart disease or stroke. That’s a pretty high number. What this usually means in mainstream medicine, where specialists manage conditions and not patients, is that any person who is diabetic needs to make sure his or her blood pressure, cholesterol and triglycerides are under control. And, by “under control,” we mean that the patient is taking his or her medication like a good little boy or girl.
The term is “comorbidities.” This is a term used to describe two or more diseases that run alongside one another. Like diabetes and heart disease.
But what if our view on this was entirely wrong?? What if, in reality, diabetes and heart disease are the same condition, just with different outward expressions?
Let’s boil it down to a common denominator: blood vessel health (although “vascular health” sounds much more trendy). No one has a heart attack or stroke until he or she has a problem with the blood vessels feeding these organs. Healthy blood vessels don’t get filled with plaque and throw off blood clots to clog smaller arteries. And few things are more deadly for your blood vessels than the prediabetic and diabetic conditions.
This is why prediabetes is so incredibly bad for you as well–because your blood vessels are being destroyed in the process. The links between heart disease and diabetes are already strong and undeniable, but I suggest that they are along the same continuum. People who die of a heart attack just didn’t live long enough to get diabetes, but you can bet that almost all of them where prediabetic.
This also means that the prevention of these two conditions is the same. I can’t think of one lifestyle change that would benefit diabetes and not heart disease and vice versa. Which makes everything easier because you just have to focus on an anti-diabetic lifestyle and you get more bang for your buck. Contrast this with medical therapy, where diabetes is managed with diabetic medications, but your heart disease risk is managed with blood pressure drugs, statins to lower cholesterol and aspirin or blood thinners to prevent clots from forming. We still treat the two as separate conditions and manage them independently.
So why the long-winded discussion? It relates to this particular study linking HbA1c levels and heart disease risk in non-diabetics with no prior history of cardiovascular events.
For those of you not familiar with HbA1c (also referred to as glycosylated hemoglobin, hemoglobin A1c or just plain A1c). This number on your bloodwork tracks what your blood sugar levels have been doing over an average of about 3 months, using red blood cells (which live about 3 months). Here’s how the numbers break down:
- An ideal number is in the low 5’s.
- Prediabetes is considered between 5.7 and 6.4%
- Anything over 6.5% is consistent with diabetes.
- For a medicated diabetic, under 7.0% is good–too much lower may kill you off faster.
- However, for LIFESTYLE, there is no number too low for a diabetic.
With this in mind, you can understand just how bad the news from this study are. Keep in mind that all the patients in this study had an HbA1c less than 6.5%:
- As HbA1c levels increased, there was an increase in the presence of heart disease and number of blood vessels involved.
- Those with higher HbA1c levels had a 280% higher chance of having heart disease.
- Those with both higher inflammation (as measured by hsCRP) and HbA1c levels closer to 6.5%, there was a 418% higher risk.
- The ideal cut-off value of HbA1c was below 5.6%.
That last bullet point, #4 above, pretty much means that 2/3 of the US alone is well on their way to heart disease. It’s beyond time to get serious about this. And getting back to my earlier point, this study basically uses a “diabetic” blood test to determine how much at risk someone is for developing heart disease. Doesn’t get more closely associated than that.