Question: I can't make heads or tails of the new American Heart Association guidelines. What should I be most concerned about? My cholesterol? My family history of heart disease (my father died of a heart attack). My blood sugar (I have pre-diabetes).
Dr. Hibberd's answer:
We have to consider what factors can we change and how serious is each that we can modify? Clearly your family history is a risk factor that you can't modify, but will affect how aggressively we treat you.
The presence of pre-diabetes tell me that you have some weight management issues to deal with, and the sooner the better. This will be the most serious predictor of your future health, and you have time now to be pro-active to delay the onset of diabetes.
Stop smoking, drink alcohol in moderation if at all, tone up and aim for an ideal body weight. Sometimes glucose control needs a little help with metformin, even with pre-diabetes, so consult an endocrinologist or your family doctor for an exam and advice here. Don't forget to exercise and limit your carbohydrate intake, increase the fiber in your diet, and follow sensible dietary habits.
You also need to check your cholesterol. I recommend that my diabetes patients have LDL readings of less than 100 and ideally 80. Your triglycerides will be elevated if your glucose control is not good, so concentrate on your glucose management to fix the triglycerides. You may indeed be a good candidate for omega-3 supplementation with fish oil and perhaps may even need to take Crestor or another statin.
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