Heart disease serious risk for diabetics

From Rhonda Rowland
CNN Medical Unit

ATLANTA, Georgia (CNN) -- Diabetics are at increased risk for heart disease, experts say, but many patients and the doctors who treat them aren't aware of the danger.

"If you have diabetes, it's almost as though you've had your first heart attack," said Dr. Frank Vinicor of the Division of Diabetes Translation at the Centers for Disease Control and Prevention.

The topic is taking center stage at the annual conference of the American Diabetes Association, which began Friday in Philadelphia, Pennsylvania.

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The incidence of diabetes is on the rise both in the United States and in other parts of the world, and . doctors estimate 75 percent of people with diabetes die from heart disease or stroke.

"Many people with diabetes of many years' duration have a heart attack -- they don't even feel it -- and it's not until their second or third episode that something significant happens and they die of it," said Dr. Victor Silverman of Saint Joseph's Hospital in Atlanta. "If you screen them, you can prevent all this."

But not all doctors screen their diabetic patients for heart disease.

A survey of 200 primary care physicians commissioned by Washington Hospital Center found that while most doctors knew about the A-1-c test that's used to monitor blood sugar control, only one-fourth knew the importance of cholesterol tests for diabetics and just 5 percent mentioned blood pressure.

"I think in our minds and people's minds with diabetes, diabetes was only a sugar disease," explained Vinicor. "Now we see that it's more than that. It's also a lipid-fat disease, a blood pressure disease. That's sort of a new way to think about it."

Vicki Womack, who has had diabetes for 39 years, initially resisted her doctor's efforts to administer a stress test.

"His opinion was that if you have diabetes long enough, then you have heart disease and it's just a matter of degree," Womack said. "So I took the stress test and doggone it if he didn't turn out to be right."

Researchers aren't sure why diabetics have a higher risk for heart disease, but they say intervention to lower blood pressure and cholesterol can greatly reduce the chance of dying of a heart attack.

Womack now takes aspirin and medicine to lower her cholesterol and blood pressure, in addition to the insulin that helps control her blood sugar levels.

"Now that I've had my experience with serious complications and I've talked to others with similar experiences, I understand that diabetes is one of the scariest public health issues that we face," Womack said.