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 percent 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 and can affect quality of life, 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 don’t affect each other.

With that approach in mind, here are some tips for managing both conditions in a way that feels right for you. 

Set meaningful goals

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

“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 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. Instead, they should be milestones that give you a sense of progress and accomplishment, says Dr. Ogunwole.

Review your medications

Multiple chronic conditions often mean multiple medications, and it’s a good idea to review what you’re taking with both your cardiologist and your endocrinologist to see if there are meds 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 as well as heart failure, according to Mansur Shomali, M.D., 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,” he says. “SGLT2 inhibitors is a group of medications that have been proven to reduce blood glucose and A1C in people with Type 2 diabetes. Clinicians are excited because they have 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 percent reduction in cardiovascular deaths in heart failure patients.

Consider your plate

Talking to your doctors about goals and medications is essential, but what’s happening around the table matters, too. A major part of that will be centered around what you eat and drink, since those choices can have a big impact on both conditions.

“When a person with diabetes develops 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 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 no-salt options when possible.

Focus on other lifestyle changes

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

Exercise is also important, but 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 work out 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.”