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Open Q & A and heart health - Colleen Gladstone, C.D.E., Unity Diabetes & Enedocrinology Services, Dr. Joan Thomas, Chief of Cardiology, Unity Health System, and Marc Natale, Executive Director, American Heart Association, February 11, 2014

colleen@unity:
Welcome to the Unity Diabetes Online Community! I’m Colleen Gladstone, a certified diabetes educator from Unity Diabetes & Endocrinology Services, and I’ll be hosting today’s chat. I’m glad you could join us this evening. We have two special guests with us tonight in honor of Heart Health Month: Dr. Joan Thomas, Chief of Cardiology, Unity Health System and Marc Natale, Executive Director, Rochester chapter of the American Health Association.

colleen@unity: 
We’re excited to answer all of your diabetes questions. We’re excited to answer all of your diabetes questions. We are excited to answer all of your diabetes questions.

colleen@unity:
Before we get started let me just tell you how we’ll address your questions and comments today. We answer questions one at a time, in the order that they are posted to the site, and there might be a slight delay as we respond to each question. It may take a few minutes for us to type answers to your questions, so please stay logged-in to the chat to see our response, even if it takes a few minutes. And you might need to refresh every few minutes to keep up with the latest posts in the chat if you switch to another application on your computer. Let’s get started.

colleen@unity: 
Dr Thomas, can you explain why people with diabetes are at higher risk of heart disease?

sassy35:
Is there a time of day that's best to check your blood pressure?

Dr. Thomas@Unity:
Diabetes affects blood vessels of the cardiovascular system and can cause inflammation of the arteries making them vulnerable to plaque and blockage formation.

Dr. Thomas@Unity:

If you take medication, I would vary the times so that you check it early in AM before you take your medications and then later in the day to see if they have improved your blood pressure.

Jgpratt :
My mother is a type 1 diabetic – are there different risks that she should be concerned with than someone dealing with type 2 diabetes?

sassy35:
Dr. Thomas - how do medications impact blood pressure?

Dr. Thomas@Unity:

Type I diabetes can cause low blood sugar, Type II less likely. Both can lead to heart disease.

Dr. Thomas@Unity:

Medications all work differently to improve blood pressure. There are six classes of medications. Some are diuretics, some dilate blood vessels, some decrease the resistance in blood vessels. Some medications work together better than alone.

Marc @ AHA:
@ Jgpratt – The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. As Dr. Thomas mentions, adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes.

colleen@unity:
How does diabetes affect cholesterol?

lucyblue:
Wow really, what would be recommendations to lower the risk of heart disease and/or stroke for people with diabetes?
Dr. Thomas@Unity: 
Diabetes and smoking are the two risk factors most likely to lead to early heart disease in men and women.

Dr. Thomas@Unity:

Diabetes when not well controlled can raise triglycerides which is a fat similar to cholesterol and is considered a risk factor when elevated for heart disease.

sassy35:
What are things that help people quit smoking?

Jgpratt :
Thank you Dr. Thomas and Mr. Natale!

Dr. Thomas@Unity:

If someone has diabetes, controlling it and having optimal levels of blood glucose and HgbAIC are important to prevent the complications of diabetes such include heart disease, kidney disease, retinal hemorrhages, etc.

colleen@unity: 

What can people do to reduce triglyceride levels?

Marc @ AHA:
@lucyblue – Medications may be needed to manage blood sugar, others are lifestyle changes like quitting smoking as Dr. Thomas mentions. Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.

Dr. Thomas@Unity:

To quit smoking there are several ways available, none of which work for everyone. Nicotine gum, lozenges, patches, medications to reduce the craving for cigarettes. The E-cigarette has become more popular, but seems to be helping some people.

lucyblue:
Thank you Marc and Dr. Thomas!

Marc @ AHA:
Yes E-cigarettes have received a lot of attention lately, however the lack of regulation has caused a lot of speculation.

Dr. Thomas@Unity:

The same dietary changes that lower cholesterol can reduce triglycerides. Decreasing your intake of saturated fat in meat, butter, cheese and fried food will all help to reduce triglycerides.

colleen@unity:
How does exercise affect cholesterol and heart disease?

Marc @ AHA:
@sassy35 - we have a great resource in NYS as well as many local smoking cessation centers. The NY Quit line actually offers free resources to eligible residents such as nicotine patches. You can contact them at 1-866-NY QUITS.

Dr. Thomas@Unity:

Regular exercise helps to lower blood pressure, lower cholesterol and therefore reduce the risk of developing heart disease. Start with 15 minutes a day if you have not been exercising and work up to a minimum of 30-40 minutes per day at least 3 days a week.

Dr. Thomas@Unity:

We also have smoking cessation classes put on by our Pulmonary specialists at Unity twice a year. It should be found on the Unity website. It is a multi-week class that helps people gradually quit smoking over, I believe, a six-week period.

lucyblue:
Marc, does the AHA have any online resources that would be helpful for people with diabetes?

Marc @ AHA:
@lucyblue – ABSOLUTELY! We have a whole site within heart.org - just go to www.heart.org/diabetes. You will find a plethora of tools, recipes, trackers and even a diabetes health assessment

sassy35:
Can just walking 15 minutes a day help you lose weight?

Marc @ AHA:
@lucyblue – The diabetes health assessment helps you learn your 10-year risk of having a heart event and you can even print customized action plans to help you lower that risk.

lucyblue:
That sounds great, I look forward to checking it out! Thanks!

Marc @ AHA:
Anytime lucyblue! You can spend hours in there. I have made several of the recipes myself.

Dr. Thomas@Unity:

Initially, if you have not done any exercise, it is a great way to start. But as part of a weight loss program the exercise physiologists say that more like 50 minutes of exercise 5 times a week can help people lose weight. But you have to work up to that amount of exercise.

colleen@unity: 

That sounds like a wonderful resource for people concerned about heart health!

colleen@unity: 

I understand that if it is difficult to exercise for an extended period, activity may be divided into several shorter periods throughout the day.

Dr. Thomas@Unity:

Yes, some people do 10-15 minutes 2-3 times a day and that works as well.

colleen@unity: 

That’s all the time we have for today. We have really enjoyed our conversation and hope that we were able to provide some insight for you. If we didn’t get to your question today or if you think of another question later on – feel free to jump into the conversation in the forum, or submit a question using our “Ask an expert” feature. Be sure to join us for our next chat Tuesday, February 25 at 8 p.m. with Sharon Spear, C.D.E. and Rebekah Kepple, R.N., Manager of Unity Cardiology Services.

colleen@unity: 

Sharon and Rebekah will be holding an open Q&A session and sharing important information about heart health!

Jgpratt :
thank you!

sassy35:
Great info tonight - thank you Dr. Thomas and Marc!

lucyblue:
Thank you Dr. Thomas and Marc - very informative and helpful info!

colleen@unity: 

Yes, thank you so much for joining us Dr. Thomas and Marc!

Marc @ AHA:
It was my pleasure!!! Thank you all for attending. 

 
 
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