DIABeducation™: At the Heart of Insulin Resistance

Two heads are better than one, especially when dealing with diabetes and heart disease — two sides of the same coin of insulin resistance. Two key forces finally joined to develop guidelines to address cardiovascular disease in people with diabetes, the American Diabetes Association (ADA) and the American Heart Association (AHA).

Readers might be surprised to learn that cardiologists and endocrinologist haven’t exactly had a united front in caring for a person with diabetes. Typically, they are focused in their own fields of practice, rather than teammates fighting against insulin resistance, a common factor for diabetes and heart disease. The ADA-AHA union is an important step for all people with diabetes.

How does insulin resistance feed heart disease?

Insulin resistance is a condition where the body doesn’t respond to the hormone insulin like it should which results in higher levels of glucose (hyperglycemia), especially after eating. A chain reaction occurs within the lining of blood vessels in the active layer of endothelial cells following food consumption. Normally, two hours after a meal, blood vessels relax (vasodilate) in response to nitric oxide, a potent, naturally-occurring substance that also reduces the build-up and tendency of white blood cells to stick to blood vessels.

With diabetes, levels of nitric oxide production are slow to return to normal and keep blood vessels from relaxing as they should. When the blood vessels are narrowed, high blood pressure follows suit. Then, if you have a delicious high-fat meal, the endothelial cell function is altered for several hours — just in time to eat again. Since all people need to eat regularly, the cycle of blood vessel dysfunction may perpetuate for up to 12 hours a day, especially for individuals with glucose intolerance.

How’s that for an in depth look at why people with diabetes often have blood pressure issues? The more we know, the more we realize we don’t know.

Make the difference

You can impact your endothelial function by your daily decisions regarding healthy eating, being active, taking medications as prescribed, and monitoring the effects of these through glucose self monitoring.

If the ADA and AHA can hook up, how about partnering with your healthcare team? Put your heads together to fight off your insulin resistance so your blood vessels can relax.