February is American Heart Month, but while you’re thinking of blood pressure and exercise, spare a thought for your blood sugar too.

That’s according to Pamela Xenakis, coordinator of the diabetes program at Carroll Hospital, who noted that people living with diabetes or even pre-diabetes are at an increased risk for heart disease.


“As a diabetes educator, one of the things I find complicates things is people with type II diabetes don’t realize most people with diabetes die from heart attack or stroke,” she said. “The statistics are staggering, it’s something like 68 percent of people with type II over 65 die of heart disease and it’s another 16 percent who die from stroke.”

The good news, Xenakis said, is that much of the advice given for heart health — getting exercise, losing excess weight, eating more fruits, vegetables and less processed food — also work for controlling diabetes. It’s a two-for-one deal.

“It’s really the same advice and it’s really the same diet,” she said.

Xenakis is fond of the Mediterranean diet, but notes that a healthy diet change has got to be one you can stick with. Making simple, easy changes along general principles — eating more fruits, vegetables and whole grains, while cutting out processed foods — can help form good habits.

“We talk more about developing habits than making healthy choices, because people are overwhelmed with choices,” she said, and starting with one change in choice to help form a good habit can be transformative.

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“Breakfast is a great place to start because for most people with insulin resistance, cold cereal is not setting yourself up for success. It is high in processed carbs, it tends to get your glucose and insulin levels up, one or the other, and you just burn through it,” Xenakis said. “To just make a switch from cold cereal to making an egg on an English muffin can have a really profound impact on someone’s health, since breakfast is something we do similarly every day.”

But diet isn’t everything. The increased risk for heart disease in people with diabetes don’t go away with a better diet, according to Xenakis.

“We used to think that having good blood sugar levels reduced your risk of cardio vascular complications, and now we know that it doesn’t,” she said. “It’s not just the blood sugar. Just having diabetes, even if it is under good control, raises your increase of heart disease and stroke.”

Exercise, in other words, is non-negotiable, Xenakis said, but it doesn’t have to mean going from the couch to running a 5K. It could just mean taking the stairs at work when going to lunch.

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“There is a lot of evidence to suggest that getting your heart rate up in 30 second intervals can be tremendously helpful for insulin resistance. If you work in a building that has stairs, it’s great to just run up those stairs for 30 seconds,” she said. “It used to be that if you didn’t do it for at least 30 minutes we didn’t count it. I didn’t even write it down. But now we know that 10 plus 10 plus 10 really does equal 30.”

Regular walk breaks can add up, and act like taking a dose of medicine over time, according to Xenakis.

“Exercise in somebody with diabetes actually works like a medication,” she said. “They are supposed to do it 150 minutes a week and it works for about 48 hours, so they are supposed to spread it over three days at least, and it has a tremendous impact.”

It’s important when making permanent lifestyle changes not to get down on yourself and to appreciate the small wins, Xenakis said. And sometimes, people need a little help: With a doctor’s referral, diabetes educators like Xenakis can give people guidance and help them reach their goals.

“Anybody that doesn’t feel confident in what they need to do to manage their diabetes should try sit down with a diabetes educator, because that’s really what we do,” she said. “We sit down and see what the person is doing and try to make specific recommendations to what they could do to just move themselves down the line a little bit.”