How to manage your health when you have diabetes and congestive heart failure

If you’ve been diagnosed with both diabetes and congestive heart failure, you’re far from alone. In fact, a scientific statement from the American Heart Association and the Heart Failure Society of America says that more than 40% of people hospitalized with heart failure also have type 2 diabetes. In people who have diabetes, the development of heart failure is four times higher than in those without the condition, the statement also notes.

Because the conditions are so closely related, it’s important to ensure they’re treated together. The American Heart Association suggests approaching care cohesively, instead of seeing them as separate diseases that do not affect each other.

One important way to do that is to keep up with your primary care provider (PCP) and specialist visits. These visits help your doctors stay up to date on how your care plan is working for you and make any adjustments needed. They can also catch any issues early, when they may be easier to treat.

Common signs of congestive heart failure include:

• Swelling in legs, ankles and feet
  • Weighing yourself each day is one of the easiest ways to recognize fluid buildup.
• Fatigue and weakness
• Shortness of breath
• Rapid or irregular heartbeat
• Persistent cough or wheezing

Common signs of diabetes include:

• Low blood sugar
  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability or confusion
  • Dizziness
  • Hunger
• High blood sugar
  • Feeling very tired
  • Feeling thirsty
  • Having blurry vision
  • Needing to urinate more often

While these visits are a vital part of your health care plan and ensure you receive comprehensive and quality care, you are the center of your treatment plan. Here are some tips you can follow daily for managing both conditions in a way that feels right for you.

#1 - Set meaningful goals

It may seem that just managing diabetes and congestive heart failure each day is enough of a goal. But, Michelle Ogunwole, M.D., a specialist in internal medicine and a research fellow at the Johns Hopkins University School of Medicine, advises that it’s helpful to think about what else you’d like to do along with your routine treatment.

“As doctors, we need to know what’s important to you and what would represent a meaningful goal for you,” she says. For instance, both congestive heart failure and diabetes can cause fatigue, so a longer-term goal might be to walk every day without feeling exhausted or to sleep better so you wake up refreshed.

These goals don’t have to be huge items like running a marathon or losing 100 pounds. Dr. Ogunwole says they should be achievable milestones that give you a sense of progress and accomplishment without adding unnecessary frustration.

#2 - Review your medications

Multiple chronic conditions often mean multiple medications. So it’s a good idea to review what you’re taking with your care team (PCP, cardiologist, endocrinology, and any other specialists) to see what options are available to you for medications that can help both diseases.

For instance, there is now a class of medications known as SGLT2 inhibitors that have been shown to help both glucose control and heart failure, according to Mansur Shomali, M.D., an endocrinologist and co-author of the book The Complete Diabetes Guide.

“There are over 100 different medications that can be used to treat people with type 2 diabetes,” Dr. Shomali says. “SGLT2 inhibitors is a group of medications that have been proven to reduce blood glucose and A1C in people with type 2 diabetes.”

They’ve also been shown to have important benefits other than just lowering glucose, such as addressing heart disease. One recent study published in The Lancet found a 14% reduction in cardiovascular deaths in congestive heart failure patients.

Talk to your care team about treatment options that may be best for you.

#3 - Consider what’s on your plate

While talking to your doctors about goals and medications is essential, another major focus should be what you eat and drink, since those choices can have a big impact on both conditions.

“When a person with diabetes develops congestive heart failure, a low-salt diet is more critical than ever,” says Karen Graham, R.D., a certified diabetes educator and co-author of Diabetes Meals for Good Health and The Complete Diabetes Guide. “Together with medications and other treatments, a low-salt diet can help reduce fluid buildup around your heart, lungs, feet, and lower legs.”

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

• Keep your overall portions small to manage your diabetes and your congestive heart failure.
• Eat more homemade foods. That way you’ll eat less processed foods (manufactured, packaged, or premade at the grocery store) and restaurant foods, which contribute the most sodium to people’s diets.
• Use less salt and salty seasonings at the table and during cooking.
• Replace salt with unsalted seasonings, herbs and spices, and lemon and lime.
• Rinse and drain canned salted foods such as canned beans, fish, and corn. Rinsing can reduce up to one-third to one-half of the added salt. Or better yet, choose reduced-sodium or no-salt options when possible.

#4 - Focus on other lifestyle changes

In addition to dietary shifts, many other lifestyle changes can have a considerable impact on both your diabetes and congestive heart failure. These include getting enough sleep, not smoking, having plenty of social interactions, and finding a sense of purpose.

Exercise is also important, but you should consult with your doctors first about what would be 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, it’s a workout you can increase in a slow but steady way. Even better? Recruit a friend or family member to get that social component in there.

“Lifestyle changes are helpful not only for your conditions, but also for your emotional well-being, and that’s crucial for quality of life,” says Dr. Ogunwole. “Especially as you age, dealing with multiple conditions can make you feel down because it can be a struggle. But finding safe, meaningful ways to connect with others and to care for yourself can have a big impact on your health.”  Talk to your PCP about how you’re feeling with managing your conditions. They can provide solutions to help with anxiety, stress, or depression.