More than 40 percent of people who have had heart attacks are diabetic and these patients are the ones who are most likely to die from their heart attacks (Lancet, 2002; 359: 2140-44). Three tests are commonly used to diagnose diabetes: fasting blood sugar, blood sugar level two hours after eating, and HbA1c, a measurement of how much sugar is attached to cells. By far the most dependable way to diagnose diabetes is to do all three of these tests. In a study in the European Heart Journal, fasting blood sugar was normal in 21 percent of the people who had diabeties (European Heart Journal, 02/13/2015). Many people have a fasting blood sugar level below 100, which is considered normal, so they are told by their doctors that they do not have diabetes and are never advised to change their unhealthful lifestyles.
Forty percent of North Americans will become diabetic, and 65 percent of diabetics die of heart disease (N Engl J Med, Dec 22, 2005;353(25):2643-2653). Nearly 30 percent of people who have heart problems have diabetes and many do not know it. High rises in blood sugar cause cell damage and your blood sugar levels rise highest after you eat, and a fasting blood sugar level test will not pick up those who have a high rise in blood sugar after meals. If your blood sugar rises over 140 two hours after a meal, you are at double the risk for a heart attack (Diabetes Care, October 2011;34(10):2237-2243).
Clues That You Are at Increased Risk for a Heart Attack
• fasting blood sugar over 100, a two-hour after eating blood sugar over 140 or HbA1c over 6.5
• LDL cholesterol greater than 100
• systolic blood pressure over 120 just before you go to sleep at night
• hydroxy vitamin D level below 30 nmol/L
• pinching more than two inches of fat over your belly
• small buttocks
• being overweight
• not exercising regularly
• smoking, or living or working with a smoker
• taking more than two alcoholic drinks a day