Correlation Between Heart Disease and Diabetes

Video Transcription:

I wanted to talk about a situation that a lot of diabetes don’t know about. It is the correlation between heart disease and diabetes.

Some statistics:
To put these in perspective, to put these two together in one person - every 80 seconds an adult with diabetes is admitted to the hospital for heart disease. Every 2 minutes another is admitted for stroke. The life expectancy is shortened by an average of 12 years to those who have both type 2 diabetes and cardiovascular disease at age 60.

Many patients don’t know their lipid levels (known as total carbohydrate, HDL, LDL, and triglycerides). When you get lab work, those goals are "tighter" for diabetes then the general population. Your total cholesterol should be below 180.

Now, people are going to think “I thought the goal was under 200”. That’s with someone that doesn’t have diabetes.

Triglycerides should be under 100, LDL below 75, and HDL above 55. One difference between the general population and diabetics is the fact that often (not every diabetic has this), a lot of us have smaller LDL particles than the general population.

On the surface that sounds really good  - “smaller is better", but think about it like this -  if your lipids are going through your blood, and going through your vessels, the smaller they are the easier it is for them to imbed themselves in the walls of your vessels. And that starts the whole sclerotic problem. There are tests that can figure out the sizes of these particles as well as the count.

Diabetes are often placed on a low-fat diet. Now the thoughts are a little different. They used to say have no more than 30% of the calories come from fat. Now they say it can be 35 to 38 percent as long as the fat is the “good fat”, but what constitutes the good fat?

There are basically three different types of fat:

    1. Mono-unsaturated fat
    2. Poly-unsaturated fat
    3. Fish oil

All the mono and the poly means is it designates how many double bonds are in the seas that make up the fat, that's chemistry that you don't have to know. Just know that's where those things come from. 

Mono-unsaturated fat includes: olives, peanuts, avocados, canola oil, the fat in olives, the fat in avocados and most nuts. You want a higher percentage of fat to come from mono-unsaturated fat because it lowers the total cholesterol, it lowers triglycerides, and lowers the LDL, but it doesn’t affect the HDL.

Why is that a big deal? Because when a lot of diabetics are diagnosed, all of those are the opposite. Your total cholesterol is way out, your triglycerides are way high, your LDL is way high, but your HDL (the good cholesterol) is way low, so you don't want to do anything to make it lower.

That's the difference between mono-unsaturated fat and poly-unsaturated fat. Poly-unsaturated fat will lower everything. But it is still better than saturated fat. Poly-unsaturated fat includes: sunflower, corn, corn oil, soybean, flaxseed oil, walnuts, canola oil, nuts.

Fish oil is slightly different, it is a poly but it acts a little differently than just having a plain poly-unsaturated fat. It increases the LDL particle size.

Why does that make a difference? Those particles are less-likely to imbed themself in the wall of the vessel, but they do lower the total cholesterol, lower triglycerides, but they can also raise the HDL a little bit. There’s nothing bad in that.

Saturated fats are mainly found in animal sources, so if you are eating any kind of animal protein, any kind of animal products, you’re going to get some saturated fat. We need all of these types of fats, but it’s the percentage in your total diet calorie wise that makes the difference.

Saturated fat raises everything across the board. The LDL particle is what a lot of doctors hone in on because it is the bad cholesterol and it can imbed itself in the vessel, whereas the HDL helps everything and you want it to go up. The lipid profile is what the physician's will order on you every three or four months. This kind of goes along with you A1C. You really need to know your numbers -  your A1C, lipid numbers, and blood pressure.

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