Additionally, medications can be expensive, even with insurance coverage. Not understanding the purpose of the medications, leads to patients stopping their medications and then suffering from debilitating diabetes complications that could have been avoided or minimized.
Melissa Young, Pharm.D., CDE, a Doctor of Pharmacy and Certified Diabetes Educator is active in community diabetes education and a representative of Granger Professional Pharmacy in West Valley City, a Health Mart pharmacy.
In order to understand the reasoning behind their multiple medications, people with diabetes need to understand the great impact that diabetes can have on the heart, blood vessels, and the body as a whole
Diabetes and the risk of Cardiovascular Disease—Why is this important?
Cardiovascular disease refers to diseases that involve the heart or blood vessels
• At least 65% of people with diabetes will die from cardiovascular disease in particular, heart disease or stroke.
• People with diabetes are 2 to 4 times more likely to die from heart disease than someone without diabetes and 2 to 6 times more likely to have a stroke.
• Diabetes is the leading cause of new cases of blindness and end-stage kidney failure
• People with diabetes have 10x the risk of having an amputation.
How does Diabetes Cause Cardiovascular Disease?
Diabetes damages the blood vessels causing cardiovascular disease through the process of atherosclerosis.
Atherosclerosis occurs when plaques of calcium, cholesterol, and fat form along the insides of the arteries. This leads to blockages in blood flow resulting in heart disease, stroke and peripheral artery disease.
Plaques may block blood flow to the arteries supplying the heart so the heart tissue doesn’t get the oxygen it needs which can result in a heart attack.
Plaques may block the arteries going to the brain leading to a stroke
Plaques may also block blood flow to peripheral parts of the body such as the legs causing peripheral artery disease. Peripheral artery disease leads to poor circulation which can slow healing of wounds greatly increasing the risk of a diabetic foot ulcer.
The plaques may also damage the small vessels in the eyes and kidneys leading to blindness and kidney disease.
There are multiple reasons that people with diabetes have a much higher rate of atherosclerosis than people without diabetes including the following:
• High blood sugar damages the inside lining of the blood vessels leading to increased plaque formation.
• The blood vessels cannot dilate properly which leads to stiffer vessels and increased blood pressure.
• High blood pressure is common in people with diabetes. This puts stress on the heart and is a major risk factor for heart disease.
• People with diabetes have a higher risk of forming blood clots which can block an artery.
• Diabetes tends to lower the good cholesterol (HDL) and raise the bad (LDL) cholesterol and triglycerides which increases the risk of fatty plaques forming in the arteries.
• Many people with diabetes are overweight or obese and are not physically active. These are major risk factors for the development of cardiovascular disease.
What can people with diabetes do to help reduce their risk of heart disease?
• Keep your blood glucose (sugar) under control
o Take all of your diabetes medications as prescribed by your health care provider
o See a diabetes educator to learn how to help control your blood glucose through meal planning and exercise.
• Monitor blood glucose on a daily basis or as directed by your health care provider.
o If you need a new meter ask your Health Mart Pharmacist as they are a good resource for getting a free meter.
• Discuss with your health care provider the possibility of taking a daily low-dose aspirin to reduce the risk of blood clots
• Keep your cholesterol under control by
o Taking medications as prescribed.
o Learn about heart healthy meal planning from a registered dietician or diabetes educator
o Discuss an exercise plan with your health care provider
• Keep your blood pressure under control
o Take blood pressure medications as prescribed
o Talk to your health care provider about a healthy weight goal and exercise plan
• Maintain a healthy weight by diet and exercise
o See a dietician or certified diabetes educator for meal planning
o Ask your health care provider about an exercise plan or for a referral to an exercise physiologist
• Stop Smoking
o Ask your Health Mart pharmacist about new medications for smoking cessation
o Discuss smoking cessation with your health care provider
A few more tips from your Health Mart Pharmacist:
1. If you are having trouble paying for your medications
o Ask your pharmacist about generic alternatives
o Ask your pharmacist about patient assistance programs from drug manufacturers
2. If you are experiencing side effects from your medications,
o Talk to your pharmacist or health care provider
3. Try to use one pharmacy so the pharmacist can assess your medication profile for drug interactions.
Granger Professional Pharmacy is located in the Granger Medical Clinic and has been serving West Valley City, since 1998. Granger Professional Pharmacy is a Health Mart pharmacy with special emphasis in the areas of hepatitis C and diabetes. Granger is one of few retail pharmacies that have a Certified Diabetes Educator on staff to meet the special needs of people with diabetes.