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For Diabetes: BP, Cholesterol Key v. Heart Disease

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WebMD Health News

Jan. 28, 2013 -- People with diabetes who want to lower their risk of heart attack and stroke should focus on controlling their blood pressure and ''bad'' cholesterol, according to a new study of more than 26,000 patients.

Controlling both these risk factors, the researchers found, made patients less likely to be hospitalized for heart attacks or strokes than those who only controlled blood sugar during the six-year follow-up.

"It's not that blood glucose is not important. It's that low-density cholesterol and blood pressure control are more important if cardiovascular disease is what you are trying to prevent," says Gregory A. Nichols, PhD, a senior investigator at Kaiser Permanente Center for Health Research.

The study is published in the Journal of General Internal Medicine.

Diabetes & Heart Disease: Study Details

More than 18 million people in the U.S. have diabetes, according to the American Diabetes Association. 

Those with type 2 diabetes (in which the body doesn't make enough insulin or use it properly) have a higher risk of heart disease and stroke.

To minimize the risk, research suggests, those with diabetes should control not only blood sugar levels but also their LDL or ''bad" cholesterol and their blood pressure.

However, Nichols says, he is not aware of any study that looked at the contribution of these risk factors to heart attack or stroke risk among people with diabetes.

For the new study, the researchers calculated all patients' average values on systolic blood pressure (the upper number of the reading), cholesterol, and blood sugar levels.

"There were actually eight different possible categories," Nichols says. These ranged from having none of the risk factors under control to having all of them under control.

Guidelines suggest that systolic blood pressure in those with type 2 diabetes should be less than 130.

"LDL ideally is less than 100 [mg/dL] and A1c [a blood sugar measure] is less than 7%," Nichols says.

Next, they looked at whether the patients had a hospital admission with a diagnosis of heart disease or stroke. During the study, 1,943 patients were hospitalized for those reasons.

Those who were in the hospital were on average 65 years old. Those who were not were on average 58.

Nichols looked at the risk factor status of all patients.

Is This Normal? Get the Facts Fast!

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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