Diabetes and Your Heart

Last Editorial Review: 3/2/2005

WebMD Live Events Transcript

Television and radio legend Dick Clark and Virginia Zamudio, president of the American Association of Diabetes Educators, shared an important message about diabetes and heart health when they joined us to chat on April 20. They have an important message that they want you to take to heart.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR: Welcome to WebMD Live. Today we are speaking with television and radio legend Dick Clark about diabetes. Joining us later will be Virginia Zamudio, president of the American Association of Diabetes Educators. They have an important message that you need to take to heart.

MODERATOR: Dick Clark, welcome to WebMD Live.

CLARK: Thank you very much. Nice to be with you.

MODERATOR: Many people were surprised by your announcement that you have type 2 diabetes. How long have you had this?

CLARK: Oh, 10 or 11 years. It isn't anything I ever talked about in public, though my family knew. I thought maybe I should go public when I heard the announcement that two-thirds of the people with diabetes die of heart disease or stroke and it seemed like a good idea to spread the word that this is rather startling news.

MODERATOR: Everyone should know that Mr. Clark is joining the American Association of Diabetes Educators to launch Diabetes: Know the Heart Part, a national public education campaign to alert Americans to the fact that diabetes and heart disease are closely related.

CLARK: You know the leading cause of death in adults with diabetes is heart disease. Actually, two-thirds of all the adults with diabetes die from heart disease or stroke. That's a pretty startling statistic.

MODERATOR: It certainly is. How are you managing your diabetes?

CLARK: Well, I started out 10 or 11 years ago with diet and exercise. Obviously, it didn't succeed that well, so they put me on medication. And these days, in all honesty, I am very, very attentive to my diet and I pay a lot more attention to my exercise, because I don't want to fall into those statistics.

MODERATOR: One of the comments that we've heard here at WebMD on our message boards, when people found out that you have type 2 diabetes, was that maybe this will help break the myth that people with type 2 diabetes are all overweight and sedentary. Dick Clark is obviously neither.

CLARK: Well, you know, I ran into a young woman earlier today who at most weighed 87 or 90 pounds and she had diabetes. So it has nothing really -- I think it's luck of the draw, really, as to what you physically look like. It's something that you should go to your health care provider and find out first of all, do you have diabetes and if you do, then he or she will probably put you on an exercise program with a diet involved, and if necessary, they'll prescribe a medication.

MODERATOR: We're talking about lifestyle changes here, not just a simple quick-fix diet.

CLARK: Oh, yes. The main thrust of this whole thing is that compared with adults without diabetes and heart disease, adults with diabetes are at a tremendously increased risk of heart attack and stroke, even if their cholesterol is normal. So you've got to wake up, find out first of all, do you have the problem, and if you do, handle it. The scary thing is, you would think that everybody with diabetes knows everything, all about it and all the details. The amazing thing is two-thirds of the people with diabetes do not realize they are at risk for heart disease and stroke.

MODERATOR: So it's important not just to maintain your sugar levels, but also to maintain your heart health. What are you doing in particular to help with your heart?

CLARK: Exercise probably is the most important thing for me. I get a little more than I used to. I spend only 20 minutes a day, because frankly, that's all the time I've got after I get up. I watch a little television, I do some weights and walking and rowing and other stuff that gets my heart beating a little faster.

MODERATOR: Is it a challenge with the busy schedule you keep?

CLARK: Well, it's a challenge when I'm on the road traveling, and as much as I hate exercise, I've got to admit I do a little more walking. I move around the room. While I'm in New York, I happened to have my weights here, so I use them, but when I'm on the road it's tougher, but you've got to get out and move around.

MODERATOR: How do you maintain such a high energy level?

CLARK: I've always been sort of that personality. I've always liked a lot of activity in my life, a lot of things going on. Multitasking, before it was a common word, was part of my lifestyle.

MODERATOR: How is your heart at this point?

CLARK: To all intents and purposes, it's fine, and I go in for a check-up every couple of months, so I keep a close eye on everything.

MODERATOR: So you're not just getting your blood sugar checked, you're getting your heart checked, as well?

CLARK: Oh, yes. You've got to take this condition very, very seriously; work with a doctor, try to manage your diabetes as best you can with exercise and diet, and if he or she prescribes it, take a medication.

MODERATOR : Just yesterday the American College of Physicians announced that their recommendations now include cholesterol-lowering drugs for almost all people with diabetes, regardless of their cholesterol count, because of the strong connection between diabetes and heart disease.

CLARK: Well that only backs up what I'm saying from an amateur's standpoint. I rely on the official people in the know to tell us what to do, and that sounds like good advice.

MODERATOR: Anything else you would like to tell us today?

CLARK: Only if you need more information you can go to the Internet and go to www.knowtheheartpart.com, or if you're old fashioned and want to make a call, you can call 1-800-224-4089 for a free brochure and all sorts of helpful information.

MODERATOR: Thank you so much for sharing with us today. We were all quite concerned when we heard that America's oldest teenager was suffering from diabetes. We want you to hang around for a lot longer.

CLARK: I certainly plan on being around. Thank you very, very much for the time.

MODERATOR: Now joining us is Virginia Zamudio, president of the American Association of Diabetes Educators. Welcome to WebMD live, Virginia.

ZAMUDIO: Thanks for having me.

MODERATOR: Tell us about your new campaign, Diabetes: Know the Heart Part.

ZAMUDIO: Diabetes: Know the Heart Part is a public awareness campaign that is being put on by the American Association of Diabetes Educators and Dick Clark and Merck & Company, to educate adults with diabetes about the risk for heart disease.

My goal as a diabetes educator is to help adults with diabetes understand that they need to work with their health care provider to not only control their blood sugar level, but to manage the risk for heart disease.

MODERATOR: Why is heart disease such a problem for those with diabetes?

ZAMUDIO: Well, it is much more common in people with diabetes because high blood sugar levels actually cause the blood vessels to get thicker and less elastic and so it makes it harder for the blood to pass through those vessels.

And cholesterol also plays a role. People with diabetes often have higher levels of fat or lipids in the blood, and that leads to more clogging and narrowing of the blood vessels.

In fact, two out of three people with diabetes are unaware that there is a link to heart disease and two out of three people with diabetes end up eventually dying from heart disease or stroke. So it's quite a significant problem, but not that much awareness.

MODERATOR: So is heart disease the major killer of people with diabetes?

ZAMUDIO: Yes, it is.

MODERATOR: Are you aware of an article in the Annals of Internal Medicine published by the American College of Physicians recommending that nearly all people with type 2 diabetes be placed on statin drugs?

ZAMUDIO: I am aware of that, and that's very similar to recommendations and guidelines from the American Diabetes Association. The recommendations are that adults with diabetes need to work to keep their LDL or the "bad" cholesterol less than 100. We do that with good healthy eating habits, with regular physical exercise, and sometimes the doctor will assess a situation and prescribe a medication that's right for that patient.

MODERATOR: What other recommendations does the ADA have for people with diabetes in terms of maintaining heart health?

ZAMUDIO: Well, we know that high blood pressure is more common in adults with diabetes, and having high blood pressure substantially increases the risk of stroke and other cardiovascular complications. So the ADA guidelines are recommending a blood pressure goal of less than 130 over 80 for adults with diabetes. So these are numbers that people need to be aware of and work with their doctor and change their lifestyle so they can reach those targets and reduce their risk.

MODERATOR: What about the role of exercise?

ZAMUDIO: Well, physical activity is so important. It does help to lower high blood pressure; it helps to improve circulation; and for most of us who need to lose a little weight, it certainly helps meet weight goals, and that can be a factor in type 2 diabetes, as well.

MODERATOR: Why do you think that so many people are unaware of the connection between diabetes and heart disease?

ZAMUDIO: Well, I think for a long time we've been very aware of the other complications of uncontrolled diabetes, such as amputations and blindness and kidney failure, but the studies that have been done in recent years are really making it clear to us about that link with heart disease and now that we have the evidence that has come forth through the research, we have to get that word out to the public.

MODERATOR: And so the goal of your group is to make sure that everyone knows the link between diabetes and heart disease and stroke?

ZAMUDIO: Right. And to realize that managing diabetes is not just about sugar any more, it's also about managing the risk for heart disease and taking proactive steps so that they can avoid cardiovascular complications, or at least delay them.

There's a particularly startling statistic that has recently come out, and that is comparing adults with diabetes and heart disease -- actually comparing people with diabetes who have never had a heart attack, they're already at the risk level as someone without diabetes who's already had a heart attack. And that's even if their cholesterol is normal.

So it is important to manage cholesterol, but just to be aware, just by virtue of having diabetes, it automatically puts the person in a higher class of risk. So they need to pay attention to those lifestyle issues and keep things under control.

MODERATOR: So that for someone with diabetes, when they're working with their diabetes educator on their diet, they need to take a look at the total picture with that diet, in terms of sugar control, cholesterol control, and weight management?

ZAMUDIO: Right. All of those goals need to be addressed. And a diabetes educator certainly can help a person look at his or her eating habits and make some small adjustments, so that the meal plan is practical, doable, and sustainable over a lifetime.

We try not to call them diets, because that's usually something short-term to meet a goal and then you don't do it any more. But it's really a lifestyle change. And the steps that are taken to control diabetes are also the same steps that help to control the risk for heart disease.


Diabetes is defined best as... See Answer

MODERATOR: The best person for someone with diabetes to work with to make sure that he or she is coordinating all of their new lifestyle eating habits is a certified diabetes educator.

ZAMUDIO: Well, it certainly is a team effort; managing diabetes, managing heart disease, it's a team effort. And the person with the disease is really at the heart of that team and the primary health care provider is certainly a very important part of the team, but in terms of learning how to make those lifestyle changes and change the behavior for a lifetime, that's when a certified diabetes educator is the person that is best qualified to help the person reach those goals.

If people want to find a diabetes educator in their local area, there is a number that they can call, and that is 1-800-TEAM-UP4. That's a hotline with the American Association of Diabetes Educators.

MODERATOR: That's great. It's important to manage the entire picture, and certainly your physician will be able to assess whether or not you need any medications to deal with your heart issues, when you have diabetes.

ZAMUDIO: That's correct. That is the area of expertise that the primary care provider would be looking at -- all of the labs, the entire situation, and determining if medication is another part of their therapy, in addition to lifestyle management.

For people who want to get a little more information about this, they can call a number with Merck to get a free copy of Diabetes: Know the Heart Part brochure. If I could give you one more 800 number: 1-800-224-4089, or they could visit the web site at knowtheheartpart.com.

MODERATOR: So let's just go back over the goals, then. We want the LDL, the bad cholesterol, less than 100?


MODERATOR: We want to control the high blood pressure, with a blood pressure goal of less than 130 over 80?

ZAMUDIO: That's correct.

MODERATOR: And we want to make lifestyle changes, not just a quick diet fix. Diabetes is for life, and you need to make your eating habits and your exercise habits, lifetime habits.

ZAMUDIO: That's right. And it's good for the whole family. It's really a lifestyle of moderation. And the whole family can benefit. Because we know that diabetes is largely based in genetics and even if the younger family members don't have diabetes, they certainly are at risk. It's good to get them started on those healthy lifestyles early on.

MODERATOR: The message is, take care of your heart.

ZAMUDIO: That's right. Take care of your diabetes, take care of your heart.

©1996-2005 WebMD Inc. All rights reserved.

Health Solutions From Our Sponsors