House Calls

SPR 2018

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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Treatment Options and Proactive Prevention For diabetics, treatment focuses on controlling insulin and blood sugar, or glucose, levels in the blood. Among heart disease patients, the goal is to prevent artery blockage to keep blood flowing and the heart pumping. Historically, accomplishing both of these goals could be a challenge for diabetics as, in 2007, a retroactive study found a common medication used to treat diabetes was associated with an increase in cardiovascular event rates. That study prompted the FDA to pass a regulation requiring new diabetes drugs to prove they do not increase patients' risk for heart problems, ushering in additional heart-healthy medication options for diabetics—some that even help reduce one's risk for cardiovascular events. The three primary categories of drugs used to manage diabetes today include: • Incretins: A class of oral medicines that work through a signaling hormone in our intestines to regulate the body's release of insulin, help lower glucose production, and create a satiety effect, which can lead to weight loss. The incretin class includes DPP-4 Inhibitors (these have shown cardiovascular neutrality, meaning they don't negatively impact heart health) and GLP-1 Agonists (a more potent incretin that's linked with cardiovascular benefits). • SGLT2 Inhibitors: This groundbreaking, relatively new class of drugs causes the body to urinate out glucose, lowering blood sugar in conjunction with calorie (i.e. weight) loss. SGLT2s have also been shown to lower cardiovascular event rates, making them ideal for a diabetic patient who has additional heart disease risk factors. • Metformin: Introduced in 1995, this remains the gold standard treatment for type 2 diabetes treatments thanks to its affordability and "weight neutral" characteristics (meaning it doesn't promote weight gain). "Diabetics have a greater risk of both microvascular diseases and macrovascular issues like stroke, coronary heart disease ..." —DR. LOUIS C. HAENEL Individual patients respond differently to each drug, but there have never been better options for treating diabetes. "It's Shangri-La when we can provide cardiovascular protection, glycemic reduction, and weight reduction," says Dr. Haenel. Even so, treating diabetes and heart disease isn't always simple. Rather, care is based on long-term preventative strategies to reduce the risk of a life-threatening event (see below for ways to do so). "The management and treatment of diabetes and heart disease closely overlap," says Dr. Haenel. "With both, success depends on avoiding simple sugars, getting regular exercise, and controlling weight. It comes down to maintaining a healthy lifestyle." Since being diagnosed with hypertension in 2015, Ralph has adopted a new diet and exercise plan, plus a regime of cardiovascular-neutral or heart-healthy medications. Today, he is down 76 pounds and no longer requires insulin. ARE YOU AT RISK FOR HEART DISEASE? There are many risk factors for heart disease—five major and a handful of minor. THE TOP 5 RISK FACTORS ARE: - Hypertension (high blood pressure) - High cholesterol - Cigarette smoking - Family history - Diabetes Secondary risk factors include age, gender, having a Type A personality (i.e. often experience stress), and being male. Luckily, there are STEPS YOU CAN TAKE DAILY TO REDUCE YOUR RISK for the disease, even if you're prone to it: Get 30 minutes of moderate-intensity exercise each day. Obesity dramatically increases both heart disease and diabetes risk, so get your blood pumping to strengthen your heart and stave off weight gain. Clean up your diet. Reducing your intake of salt, sugar, and saturated fats will help ward off both diabetes and heart disease, and help to reduce high cholesterol levels that can create plaque in your arteries. Meditate. Just a few minutes of quiet reflection a day can reduce stress levels and lower blood pressure, which helps protect your blood vessels. Quit smoking. Both nicotine and carbon monoxide from cigarettes destroy blood vessels' inner lining. h o u s e c a l l s { spring 2018 } 33

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