Sugar, Diabetes and Heart Disease

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This week we explore part 2 of our 4-part series on the 4 things diabetic heart patients have to monitor: sugar consumption and its effect on blood glucose, as well as heart disease.

There’s a wealth of great resources for diabetes, so we’re not going to try to duplicate them. We assume you already know that managing blood glucose (blood sugar) levels is a hallmark of diabetes treatment. The question for diabetic heart patients is how that interacts with heart healthy eating.

The correlation between high blood sugar and heart disease is strong, according to statistics from the American Heart Association. One of the reasons may be that high blood glucose causes the blood vessels to contract more than normal, increasing blood pressure. Other reasons may include the frequency of other concurrent conditions that are often present in patients with diabetes, including hypertension, high cholesterol levels, high triglycerides, obesity, and sometimes a lack of physical activity.

Experts state that the majority (i.e., 65-66%) of diabetic patients will develop heart disease, and, in fact, Wayne’s Cardiologist estimates that 40% of his patients are diabetic. So, the need for coordination of optimal dietary recommendations for these two conditions is high, but there seem to be few resources on how they overlap and the competing needs they present.

In any event, patients with diabetes have to severely limit their intake of simple sugars and have to watch their intake of carbs, even healthy carbs. Recipe adjustments include eliminating added sugars, limiting most carbs, and replacing them with healthy fats, protein, and healthier carbs.

For diabetic patients who have a sweet tooth, artificial sweeteners can be a stopgap measure for trying to control sugar cravings. However, some older artificial sweeteners have been shown to raise the risk of cancer and other diseases. Others may have an effect on the body’s insulin resistance and metabolism of glucose (see Resources for more information). Sugar alcohols raise the blood glucose, but not as much as sugar, so they might be less harmful from the standpoint of blood glucose, but they can cause bloating and may have a laxative effect. It is safe to assume that not enough is known about some of the newer artificial sweeteners to be certain of their effects.

The basic recommendations should be no surprise: minimize the consumption of sweets, especially highly refined, junky sweets. Hopefully, the box of snack cakes that once occupied a spot in the pantry is just a memory. Other than a few sugar-free chocolates and cookies to satisfy sudden cravings, the use of true sweets should be limited to special exceptions. The medical necessity of maintaining a healthy blood glucose generally needs to override the temporary pleasure of eating anything you want.

In the diabetic community (apart from heart considerations) there are two approaches to this issue:

  1. A traditional, balanced lifestyle approach, eating complex carbs, healthy fats, increased consumption of vegetables, and meats with low saturated fat;
  2. A low-carb, high-fat approach that controls drastically reduces most carbs, replacing them with fats and protein.

The tightrope that diabetic heart patients walk is learning how to control blood glucose without leaning too heavily on things that may contribute to heart disease, like saturated fats and sodium. So far, we are taking a traditional, balanced approach of trying to minimize carb consumption, keeping those we do consume as healthy as possible, and avoiding overuse of saturated fat products.

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