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CNN Live Saturday

Study Finds Diabetes Patients Are at Risk for Heart Disease

Aired June 23, 2001 - 17:11   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
STEPHEN FRAZIER, CNN ANCHOR: Doctors who study and treat diabetes are in Philadelphia this weekend, and we're going to spend some time now on their findings there. One major area of focus this year is the complication of heart disease in diabetics. A new study finds most patients don't even know they are at risk for heart disease. CNN's Rhonda Rowland has more on how this problem is being handled.

(BEGIN VIDEOTAPE)

RHONDA ROWLAND, CNN MEDICAL CORRESPONDENT (voice-over): Vicki Womack has lived with diabetes for 39 years. She depends on an insulin pump to maintain normal blood sugar levels in order to avoid problems with her eyes, kidneys, nerves and feet. But she never knew that as a diabetic she was also at high risk for heart disease. So when her doctor recommended a stress test, she resisted.

VICKI WOMACK, DIABETES PATIENT: His opinion was that if you have diabetes long enough, then you have heart disease, and it's just a matter of degree. And so, I took the stress test, and dog gone it, if he didn't turn out to be right.

ROWLAND: 75 percent of people with diabetes die from heart disease or stroke.

DR. VICTOR SILVERMAN, ST. JOSEPH'S HOSPITAL, ATLANTA: Many people with diabetes of many years duration, they have a heart attack, they don't even feel it, and it's not until their second or maybe even third episode that something significant happens, and then they die of it. If you screen them, you can prevent all this.

ROWLAND: But not all doctors screen their diabetic patients for heart disease. A survey of 200 primary care physicians, commissioned by Washington Hospital Center found, while most knew about the A1C test to monitor blood sugar control, only one-fourth knew the importance of cholesterol tests, and just 5 percent mentioned blood pressure.

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

ROWLAND (on camera): Researchers are not sure why people with diabetes are at high risk for heart disease. What they do know is -- just like in nondiabetic patients -- if blood pressure and cholesterol levels are lowered, the chances of dying from a heart attack are greatly reduced.

(voice-over): To avoid even more heart trouble, Womack now takes cholesterol and blood pressure-lowering medicine and aspirin, in addition to her insulin.

WOMACK: Now that I've had this -- 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.

ROWLAND: Rhonda Rowland, CNN, Atlanta.

(END VIDEOTAPE)

FRAZIER: Another thing coming out of Philadelphia this weekend is that apparently, millions of American suffer from diabetes and don't even know if. At this weekend's conference, doctors are working on that, and here to talk about it is Dr. Richard Jackson, senior physician at the Joslin Diabetes Center in Boston and a professor of Harvard medical school. He is joining us from Philadelphia.

Dr. Jackson, thank you for stepping away from the conference to talk with us.

DR. RICHARD JACKSON, JOSLIN DIABETES CENTER: Well, thanks for the opportunity.

FRAZIER: You mentioned a minute ago that people with diabetes need to hear things, and you are talking to other physicians there, how many are working on this? It is an old disease, I didn't know it was a source of new work?

JACKSON: Well, I think that diabetes -- although you are right, it is an old disease, it's one that we don't really treat very successfully. Even patients who do well find that the effort is often overwhelming.

What they don't know maybe is that there is thousands and thousands of researchers and doctors, educators, who are working on trying to figure out better ways for them to take care of their diabetes.

FRAZIER: And millions and millions of sufferers, apparently, about 60 million in the U.S.?

JACKSON: Right. We think that many with diabetes, and maybe that many more who have it and don't know that they have it, which is even more worrisome.

FRAZIER: How is that possible that you have it and not know?

JACKSON: Well, the symptoms may occur slowly. They are often urinating more, drinking more, getting up at night to urinate, blurring of your vision, infections a little more often than usual.

The thing is that if you are aware of the symptoms and ask your doctor, he or she can easily do a test to find out if you have diabetes.

FRAZIER: And if that's something you find out, are you then doomed for life? I mean, what does that...

JACKSON: Well, this is, I think, one of the most important things for people to understand, is that if you have diabetes and you learn yourself what you need to do to take care of it, the results can be very, very good. We know that we can be very successful at helping people to prevent the complications.

That means that at the very beginning, they need to do the sorts of things that you were talking about earlier in the show. There are five tests that really tell them where they are. The A1C test that looks at their average blood sugars -- extremely important -- tells them the risk for future problems is higher or lower. The cholesterol level, their blood pressure level, an eye exam by someone experienced is very valuable, and a kidney test, called the micro-albumen test.

These are all things that if they find out where they are, they will be able to take measures that will prevent them from having troubles later.

FRAZIER: Are these things that you could improve the levels of, if you were to follow the exercise and dietary recommendations of your physicians?

JACKSON: Well, the most common kind of diabetes and the kind that's increasing most markedly is type II diabetes. And in type II diabetes, lifestyle is very important. Exercise especially, then what you eat, and then your weight after that; doing things smart, like not smoking.

These are difficult things to do, however. So what you need to do is find ways for you yourself individually to have those occur, find other people to help you, exercise physiologists, dietitians, diabetes educators, and keep work on it, and know where you are with these different tests, so that you will know what your risk is.

FRAZIER: One final question, doctor, not about personal risk but about the nation's health as a whole. You heard Vicky Womack, the sufferer in that early report called this "a public health problem." Is it because we are becoming sort of fast food nation, and obesity is leading to this?

JACKSON: Yeah, it seems clear that one of the reasons, the main reasons that type II diabetes is increasing is because of this change of lifestyle, where we are tending to be less active, we eat foods that are concentrated in calories, a lot of fat, and our weight is going up. And these things make it more likely that you will get type II diabetes, or if you are going to get it, they make it more likely that you might get it when you are 40 instead of when you're 70. So, that working on these lifestyle modifications at a very early age is important. And if you have diabetes, you need to think about them, but you also need to think about getting your children into habits that will help them later on in life.

FRAZIER: Right. Dr. Jackson, thanks for joining us and for stepping away from the conference. We will let you get back to that now. We will spend a little more time on this tomorrow.

JACKSON: OK, thank you.

FRAZIER: Dr. Richard Jackson of the Joslin Center in Boston.

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