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  • The Faces of Cardiovascular Disease: Part 3

    This article is part of a mini-series, The Faces of Cardiovascular Disease, looking at the different presentations, symptoms, and root causes of a disease that affects millions of men and women around the world. First, be sure to read part 1 and part 2. In this installment, we explore the impact of type 2 diabetes on a fictional person’s life; elements of this story have been inspired by front line doctors whom we have a close connection with. Keep reading for information on future planned articles.

    How much time do you spend thinking about food?

    For me, healthy and active, food comes to mind when I’m hungry. I’m a horrible planner – the choices I make about what to put into my body are made on the fly. I try to eat “healthy”, but that “healthy” spectrum can be quite broad and is definitely influenced by my mood.

    For my dad, after 5 heart attacks, an extremely long list of meds to regulate his blood pressure, cholesterol, and blood glucose levels are part of his daily regime. Tracking what he eats NEEDS to be a priority. Those “healthy choices” I make? Turns out they aren’t so healthy when your body’s glucose handling system is compromised.

    Yogurt? My dad’s favorite brand spikes his glucose levels from a nice regulated 5 mmol/L to a spectacular 15. Half a club sandwich (without the fries he really wanted)? 17.  And that’s with all those diabetes meds he’s on. Just think what a blueberry cobbler could do!

    Every one of us will experience a peak in our blood glucose after eating. My blood glucose will level off in the 4-8 mmol/L range within an hour or two of that meal. For my dad, however, his glucose will peak far higher than mine, and if it exceeds the capacity of his diabetes meds, it will stay elevated. He’ll need an insulin injection to return his blood glucose to the normal range. That high sustained glucose – it will do slow insidious damage to his body without him even knowing it.

    So my dad needs to be vigilant about what he eats and actively avoid foods with a high glycemic index. Being able to stay in that normal blood glucose range develops with experience. That experience – it comes from pricking your finger – a lot! The glucose monitor knows what your eyes cannot tell you. Some foods masquerading as healthy will do you no good.

     

    Diabetes is a slowly developing, cumulative disease. It results from uncontrolled, sustained high blood glucose levels (hyperglycemia). Normally, insulin released from pancreatic beta cells signals muscle, red blood cells, and fat cells to absorb glucose and move it out of the blood. Consistent high glucose renders these cells insensitive to insulin (insulin resistance), so blood glucose levels stay high. This presses the pancreatic beta cells into overdrive, pushing them to produce even more insulin. These exhausted cells turn off, and eventually die, promoting insulin deficiency. In type 2 diabetes, persistent overworking and challenging the glucose handling system leads to insulin resistance and deficiency – and unresolved, sustained high blood glucose.

    High blood glucose irritates blood vessel linings. It causes inflammation and damage to the vasculature. This inflammation is a major driver of atherosclerosis. Heart disease or stroke is twice as likely to be the cause of death for diabetics compared to non-diabetics.

    Vascular damage also undermines the function of the organs they nourish. Diabetic retinopathy develops as the tiny blood vessels that feed the back of the eye are blocked. Vision changes in both eyes are a sign of this problem. For more than 60% of patients with diabetes, diabetic retinopathy is an issue. Proper kidney function also relies on blood flow through tiny blood vessel clusters (glomeruli) to filter waste from blood. Diabetic nephropathy arises as the glomeruli are damaged by high glucose and high blood pressure. Diabetics are 40% more likely to develop kidney disease than non-diabetics.

    Vascular damage caused by high blood glucose often spreads inflammation to nearby nerves. Painful diabetic neuropathies are triggered by the nerve damage wherever it occurs. Often the pain or numbness is felt in the legs and feet, but it may localize to the digestive system, urinary tract, blood vessels and heart. Up to half of diabetics will experience a neuropathy.   

     

    My takeaway – I need to eat foods that aren’t a constant overwhelming challenge to my glucose handling system. After all, my risk for developing diabetes is increased by my family history. I’ll have to be pro-active to keep my pancreatic beta cells in working order for a good long while.

    So how am I going to choose what “healthy” foods to eat? Well, not too long ago some bright minds got together and revised the Canada Food Guide. Seeing as it stresses unprocessed, whole foods – particularly fruits, veggies, and nuts that are easy to grab, it suits my lifestyle. I’ll try it out as a basis for my choices going forward.

    And my dad? His diabetes diagnosis is not a death sentence. In fact he’s been living a good long time with it. But he does need to be constantly aware of what he’s eating. His body can repair itself from the damage done by high blood glucose if he can keep it in check. Oh - and hopefully he throws in some cardio. Getting that heart rate up gets the blood pumping to all those needy organs!

    At Resverlogix, we continue to research the biology underlying CVD and other multi-factorial diseases. Click here for our published findings. We endeavour to explore the human side of the problems associated with these diseases. This allows us to ultimately better inform the novel products we develop and to improve the quality of patients’ lives.

    Stay tuned for the next article in this series where we will explore CVD risk factors unique to kidney disease and the additional biological processes that contribute to both. In addition, we will explore new and innovative treatment options.