Tips for Managing Diabetes and Congestive Heart Failure

Living with a chronic health condition can feel a bit like running track. With every lap, you have the same hurdles to jump: medications to juggle, doctor’s appointments to keep, and troublesome symptoms to navigate. And tripping over 1 hurdle can lead to another — in this case, a second chronic illness.

That’s certainly true for type 2 diabetes and congestive heart failure (CHF). These two conditions are closely intertwined. Some reports show that more than 40% of people hospitalized with CHF also have type 2 diabetes. And people with diabetes are up to 4 times as likely to develop heart failure as those without.

What’s the connection? For starters, many of the same risk factors that lead to type 2 diabetes also cause heart failure. They include:

• Being overweight or obese
• Having high blood pressure
• Having coronary artery disease

What’s more, diabetes itself is a risk factor for heart failure. That’s likely because over time, having high blood sugar damages the blood vessels and nerves that control your heart. And on the flip side, heart failure can raise your risk of diabetes. It may be that higher levels of certain hormones in people with CHF increase blood sugar and insulin resistance.

Because these illnesses are so closely related, the American Heart Association recommends they be treated together instead of as separate diseases. So, it’s no surprise that keeping your blood sugar levels in balance is the best place to start. That can help manage both conditions and keep them from getting worse. Here are more tips that do double duty. 

Did you know that you can sync your glucometer with your BlueforMe app? This digital health management tool is included with your health plan, and it can send real-time blood sugar readings to your care advocate for monitoring and support. For more information on diabetes, you can visit www.diabetes.org or you can call 844-730-2583 to see if you’re eligible for BlueForMe today.

Set small, meaningful goals.

It may feel like managing diabetes and heart failure over the long haul is enough of a goal. But it’s helpful — and motivating — to set shorter-term goals. These are goals you can reach sooner and that make a noticeable difference in your life.

For instance, both CHF and diabetes can cause fatigue. That can stop you from doing the things you love. It can also leave you feeling just blah. If a lack of energy and enthusiasm is dragging you down, think about setting a goal to walk every day. Or aim to go to bed earlier so that you wake up refreshed.

“These goals don’t have to be huge, like running a marathon or losing 100 pounds,” says Michelle Ogunwole, MD, assistant professor of medicine at the Johns Hopkins University School of Medicine. “Instead, think about milestones that give you a sense of progress and accomplishment.”

Review your medications.

Having more than one chronic condition often means taking more than one medication. When was the last time you talked through all of them with your cardiologist and endocrinologist? A lot of good can come out of these check-ins. You can:

• Talk about any unpleasant side effects and find solutions. Your doctor might suggest trying a new brand or changing your dose
• Make sure your dosages are working as well as they should
• Decide if your current medications are still necessary. Has your condition improved enough that you could forgo 1 of them? 
• Confirm that all your medications interact well together
• Bring all your medications in the original bottles with you to the appointment

While you’re at it, ask about other medications that might help treat both your type 2 diabetes and CHF. For instance, a class of medications known as SGLT2 inhibitors have been shown to help with both. They help reduce blood glucose and A1C in people with type 2 diabetes. A1C is a measurement of average blood sugar levels across the past 2 or 3 months. At the same time, a recent study found that SGLT2 inhibitors helped reduce cardiovascular deaths in heart failure patients by 14%. Given these results, it’s certainly worth asking your doctor about SGLT2 inhibitors such as Jardiance® (empagliflozin), Farxiga® (dapaglifozin), or Infokana® (canagliflozin).

Have questions about your medications? Not only can you call your doctor, you can search the private health library on BlueforMe for information and insights from experts, including registered nurses. Or use the app to connect with your care advocate for more answers. Call 844-730-2583 to see if you’re eligible for BlueForMe today.

Rethink what goes on your plate.

Some areas that influence your health — such as your genes — are out of your control. But one area where you have almost all the control? Your diet. And what you eat and drink can have a big impact on both type 2 diabetes and CHF.

“When a person with diabetes develops heart failure, a low-salt diet is more critical than ever,” says Karen Graham, RD. Graham is a certified diabetes educator and co-author of Complete Diabetes Guide: Advice for Managing Type 2 Diabetes. The reason: CHF causes fluids to build up in your body. And that can lead to swelling, weight gain, and shortness of breath.

“Together with medications and other treatments, a low-salt diet can help reduce fluid buildup around your heart, lungs, feet, and lower legs,” says Graham.

Here are 5 of Graham’s best tips to reduce sodium:

• Keep your overall portions small
• Eat more homemade food. That way you’ll eat less processed and restaurant foods. These contribute the most sodium to people’s diets
• Use fewer salts and salty seasonings. That includes onion salt, garlic salt, celery salt, and mixed seasonings such as taco flavoring  
• To keep food flavorful, use lemon and lime and salt-free herbs and spices. Some ideas: basil, oregano, turmeric, and chili powder
• Rinse and drain canned foods such as beans, fish, and corn. Rinsing can reduce up to half the added salt. Better yet, choose no-salt options when possible
• Check food labels and packaging to help you select the lowest-sodium option

Focus on self-care.

In addition to dietary shifts, many other lifestyle changes can have a big effect on your conditions and quality of life. Three key things that can help make living with chronic illness more manageable:

• Sleep. Most adults need 7 to 8 hours of sleep a night to feel their best. Getting enough shuteye helps you fight off infections. Plus, it gives your heart and vascular system a much-needed rest.
   
• Exercise. The long list of exercise benefits includes strengthening your heart and helping your body use up excess glucose. Check with your doctors first. Ask about what kind of exercise is safe and effective with your conditions. Simply starting with a few minutes of walking every day can help you set a habit, says Dr. Ogunwole. Plus, you can increase walking in a slow but steady way as you build strength.
   
• Socializing. Spending time with loved ones literally feels good. Research shows that being with friends can lower your blood pressure. It can also cause your brain to release more of the feel-good chemical oxytocin. So don’t forget to make room to spend time with the people who matter most to you. “Finding safe, meaningful ways to connect with others and to care for yourself can have a big impact on your health,” Dr. Ogunwole says.

You don’t have to navigate your chronic illness alone. You have access to programs for managing diabetes, congestive heart failure, and more not only through your doctor, www.diabetes.org, or www.heart.org, but directly through your health plan. Call 844-730-2583 to see if you’re eligible for BlueForMe today.

[Sources]

[1] Dunlay SM, Givertz MM, Aguilar D, et al. “Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement from the American Heart Association and the Heart Failure Society of America.” Circulation, vo. 140, 2019: e294-e324.

[2] Guglin M, Lynch K, and Krischer J. “Heart Failure as a Risk Factor for Diabetes Mellitus.” Cardiology, vol. 129, no. 2, September 2014: 84-92.

[3] Cardos R, Graffunder FP, Ternes CMP, et al. “SGLT@ Inhibitors Decrease Cardiovascular Death and Heart Failure Hospitalizations in Patients with Heart Failure: A Systemic Review and Meta-Analysis.” EClinicalMedicine, vol. 36, no. 100933, June 1, 2021.

[4] Brent LJN, Chang SWC, Gariepy JF, et al. “The Neuroethology of Friendship.” Annals of the New York Academy of Sciences, vol. 1317, no. 1, December 2013: 1-17.

DISCLAIMER: Florida Blue has entered into an arrangement with Wellframe to provide members with care decision support services, information and other services. This article is provided by Linkwell Health through their arrangement with Wellframe. Please remember that all decisions that require or pertain to independent professional medical/clinical judgment or training, or the need for medical services, are solely your responsibility and the responsibility of your physicians and other healthcare providers. Wellframe is an independent company that provides online services to Florida Blue members through the Blue for Me app.