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February 2009 Mayo Clinic Women's HealthSource Highlights Diabetes and Heart Disease, Going Vegetarian and Tinnitus

Diabetes and Heart Disease: Risk Intertwined

ROCHESTER, Minn., Feb. 4 /PRNewswire-USNewswire/ -- Here are highlights from the February issue of Mayo Clinic Women's HealthSource. You may cite this publication as often as you wish. Mayo Clinic Women's HealthSource attribution is required. Reprinting is allowed for a fee. Include the following subscription information as your editorial policies permit: Visit or call toll-free for subscription information, 800-876-8633, extension 9751.

What's the most common long-term complication of diabetes? Problems with the heart and blood vessels, according to the February issue of Mayo Clinic Women's HealthSource.

Cardiovascular diseases, including heart attack and stroke, account for 65 percent of all diabetes-related deaths. People with diabetes are two to four times more likely to have a heart attack than someone without the disease. For a middle-aged person with type 2 diabetes, the risk of a future heart attack is the same as that of someone who's already had a heart attack. Also attention getting: when people with diabetes have heart attacks, they are more serious and more likely to result in death than in adults without diabetes.

People with diabetes are at higher risk of cardiovascular disease because too much blood sugar (glucose) can lead to damage inside blood vessel walls. This damage makes it easier for fatty deposits (plaques) to form in arteries and cause narrowing or blockages that can lead to heart attacks or strokes.

Having diabetes doesn't mean heart disease is inevitable. Optimal control over the ABCs of diabetes, as suggested by the American Diabetes Association, can reduce heart disease risk. The ABCs are:

A1C: The best way to measure blood glucose levels over time is the glycoslyated hemoglobin A1C test. This blood test, given by a physician, reflects average blood sugar control over three months. The ADA recommends maintaining the A1C level at less than 7 percent. New research has indicated that intensive measures required to get below 7 percent might not offer cardiovascular benefits. A physician can determine the best goal for the A1C level. The test is recommended at least twice a year.

Blood pressure: High blood pressure is a common partner to diabetes. For people with diabetes, an ideal reading is below 130/80 millimeters of mercury (mm Hg).

Cholesterol levels: The optimal target is less than 100 milligrams per deciliter (mg/dL) for low-density lipoprotein (LDL) cholesterol. For high-density lipoprotein (HDL) cholesterol, the recommended level is more than 50 mg/dL for women and more than 40 mg/dL for men.

A physician can help with a treatment plan to meet these guidelines. A healthy diet, regular physical activity, weight loss, smoking cessation and limited alcohol consumption all are beneficial. Medications also may be needed. For example, research has shown that most adults with high blood pressure and diabetes require multiple drug therapies to reach blood pressure goals.

The bottom line: Risks and complications from diabetes and heart disease are intertwined. People with diabetes who manage heart disease risks can help avoid life-threatening complications.

Going Vegetarian? With A Little Planning, It's Easier than Ever

ROCHESTER, Minn. --- There's more to being a vegetarian than cutting meat from the menu. The February issue of Mayo Clinic Women's HealthSource offers suggestions for a well-balanced vegetarian diet --- and some reasons why it's worth considering.

The vegetarian menu emphasizes the food that U.S. dietary guidelines say all Americans should eat regularly --- fruits, vegetables, whole grains, beans and other legumes. Vegetarian diets often are lower in calories than the typical American diet. So it's no surprise that on average, vegetarians are thinner than their nonvegetarian peers. And eating a mainly plant-based diet can reduce the risk of heart disease, high blood pressure, type 2 diabetes and certain types of cancer.

The increasing variety of meat-free options makes the transition to vegetarian easier than ever before. With a little planning, a vegetarian diet can meet all nutritional needs. Important nutrients to include are:

Protein: Eggs, dairy products, soy products, legumes, lentils, nuts, seeds and whole grains fill this important role. Meatless products such as tofu dogs, soy burgers and texturized vegetable protein can be excellent sources of protein. Many meat substitutes, such as tofu and tempeh, are made from soybeans. Soy offers a balance of all essential amino acids, just as meat does. These meat substitutes often are lower in calories and saturated fat than meat.

Calcium: Low-fat dairy and dark green vegetables such as collard greens, kale and broccoli are good sources of calcium. Tofu enriched with calcium and fortified yogurt and juices also are options.

Vitamin B-12: This is found almost exclusively in animal products including milk, eggs and cheese. Vegans --- those who eat only plant-based foods --- can get B-12 from enriched cereals, fortified soy products or by taking a supplement.

Iron: Dried beans and peas, lentils, enriched cereals, whole-grain products, baked potatoes with skin, dark leafy vegetables and dried fruit are good sources of iron. Eating foods high in vitamin C (strawberries, citrus fruits) along with iron-rich foods can help increase iron absorption.

Zinc: Zinc is found in whole grains, soy products, legumes, nuts, wheat germ, mushrooms and peas. It's also found in dairy foods and eggs.

Ways to Minimize Tinnitus -- Troublesome Noises in the Ears

ROCHESTER, Minn. -- Ringing, whining, whistling, hissing or whooshing. Any of those sounds in one or both ears when there is no external noise present could be a sign of tinnitus.

The February issue of Mayo Clinic Women's HealthSource provides an overview of this common condition. It's estimated that 10 percent to 15 percent of adults have prolonged tinnitus that often requires medical evaluation. This form of the problem can interfere with sleep, concentration and daily activities.

Tinnitus --- pronounced as either TIN-i-tus or ti-NIGHT-us, often is caused by age-related hearing loss. Exposure to loud noises also can damage hearing and lead to tinnitus. Tinnitus can be caused by something as simple as a buildup of wax blocking the ear canal. Some medications, certain antibiotics and cancer drugs can cause or worsen tinnitus. Aspirin --- taken in excessive amounts --- can cause temporary ringing in the ears, too.

The treatment depends on the root cause. But so far, there is no cure. A medication change or removal of earwax may diminish symptoms for some people.

"One of the frustrating things about tinnitus is that there aren't any universal successful treatments," says Charles Beatty, M.D., a Mayo Clinic specialist in head and neck disorders. "The good news is that the problem usually isn't associated with a serious medical condition, and there are ways we can try to make the tinnitus less annoying and disruptive."

Treatment strategies that may be beneficial include:

  • Amplifying hearing with a hearing aid. This may help because the brain would rather process external sounds than be distracted by an internal noise.
  • Avoiding excessive noise. Ear plugs can be helpful when operating noisy machines.
  • Avoiding stimulants. Caffeine, nicotine and decongestants can aggravate tinnitus.
  • Adding background noise. Turning on quiet music, a fan or other background noises can distract the brain from the internal noise.
  • Using behavioral therapy. Relaxation techniques can help people cope with tinnitus or keep it controlled.
  • Using medications. Sedatives or antidepressants can help when the condition interferes with sleep or causes a high level of anxiety or stress.

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9751, or visit

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