When Octavio Roso was rushed to the emergency room unable to breathe and with a pain in his chest, he had no idea what was wrong with him.
He quickly found out, however, when he was diagnosed with both diabetes and cardiomyopathy, a condition that causes the heart muscle to thicken and become enlarged.
“If I had waited another day, I would’ve died,” recalls Roso of that frightening experience six years ago.
Eventually Roso, now 43, transformed his eating and exercise habits and underwent a heart transplant.
“I changed my whole life,” he adds.
Before “the world fell on my head,” Roso was one of the millions of people living with undiagnosed Type 2 diabetes. He was unaware, too, that the disease has a strong and deadly correlation to cardiovascular disease.
Diabetic adults are two to four times more likely to die from heart disease than adults without diabetes. In fact, 68 percent of people age 65 or older with diabetes die from some form of heart disease, while another 16 percent die of stroke.
Dr. Sandra Chaparro, Roso’s doctor and a cardiologist with the University of Miami Health system, said that while the real estate photographer’s case may seem extreme, surprise diagnoses aren’t unusual. That’s why diabetes is often referred to as “the silent killer.”
“If you don’t have regular visits to your doctor and regular blood tests, there’s really no way to identify it in time,” she says.
To combat this lack of awareness, last year the American Heart Association and the American Diabetes Association got together to launch an educational initiative about cardiovascular disease and death in people with Type 2 diabetes. The partnership, Know Diabetes by Heart, is a multi-year program that, among other things, helps diabetics manage the disease and its many health risks.
The diabetes-cardiovascular link is particularly worrisome among Hispanics, who tend to have a higher incidence rate of diabetes than non-Hispanic whites.
A National Heart, Lung and Blood Institute study known as the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) found that, among all Hispanic/Latino groups, the prevalence of diabetes, both diagnosed and undiagnosed was 16.9 percent, compared to 10.2 percent for non-Hispanic whites.
The incidence among individual Latino groups, however, varied, with a high of 18.3 percent for those of Mexican descent and a low of 10.2 percent for those of South American descent. (Cuban Americans fell in the middle, at 13.4 percent.)
The rate of diabetes also rose steeply with age. Fifty percent of Latino women had diabetes by the time they were 70, with men clocking in at 44.3 percent. Both rates are higher than for non-Hispanic whites.
Physicians and researchers attribute these alarming rates to many factors. Diabetics, particularly those with insulin-resistance Type 2 diabetes, usually suffer from the very conditions — obesity (especially carried around the waist), high blood pressure, high cholesterol, and little physical activity — that contribute to cardiovascular disease. When they occur together, these conditions are known as metabolic syndrome.
The traditional Hispanics’ diet hardly promotes good health either, with its dependence on complex carbohydrates.
“We have more carbs but a lot less vegetables,” Chaparro notes.
As a result, Hispanic Americans were 1.2 times as likely to be obese than non-Hispanic whites, according to a government health report. They were also less likely to be physically active.
Dr. Aldo Calvo, medical director of Broward Health’s Community Health Services, notes that “social determinants” also elevate the risk of dangerous consequences from both diabetes and cardiovascular disease.
“Many patients have no access or poor access to healthcare,” he says. “They have no insurance and when this happens, the probability is high that you won’t be diagnosed [with diabetes or pre-diabetes].”
In such cases, he adds, people can live with diabetes (or pre-diabetes) for five to 10 years without noticing the telltale symptoms, thus allowing the disease to wreak havoc on their health.
Diabetes, explains Dr. Mike Diaz, an interventional cardiologist with Palmetto General Hospital, results in inflammation and slower blood flow. This increases the potential for atherosclerosis, the hardening of the arteries, which in turn accelerates heart attack risk.
“We treat a diabetic patient who has never had a heart attack as someone who already has a heart attack,” Diaz adds.
But there’s plenty of good news.
“It’s definitely controllable,” says Dr. Lawrence Blacher, a cardiologist with Baptist Health System’s Miami Cardiac & Vascular Institute.. “Patients can do something about it. Most of the ones I see know the consequences of diabetes and they’re motivated.”
Roso certainly was.
Even before his heart transplant, he changed his eating habits. The steady diet of fast food burgers and hot dogs? Gone. Salt and sugar? Gone. The drinking? Gone too.
Now he loads his plate with fruits and veggies. He also runs, rides bikes, and plays sports on a regular basis.
“I feel so good,” he says. “I can breathe again. I can walk around again. It’s an amazing feeling.”
How to keep the diabetes-cardiovascular link in check:
▪ Know your numbers. Check your blood pressure, your blood glucose, your weight and your body mass index on a regular basis.
▪ Keep close tabs on your blood sugar if you’re pre-diabetic or diabetic. You should have A1C blood glucose level tests twice a year (should be below 5.7). Also make sure to control blood pressure levels with the help of your doctor.
▪ Tell your doctor about a family history of either diabetes or cardiovascular disease.
▪ Lose weight and keep it off.
▪ Eat right. That means more vegetables, fruits, whole grains and high-fiber foods. Reduce fried foods, red meats, sweets — any food high in salt, sugar, saturated fat and transfat.
▪ Exercise. Try for 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity per week. The American Heart Association also recommends muscle-strengthening activity at least two days per week.
▪ Don’t smoke. If you do, quit.