possible heart attack

[hawkfan]

My husband turned 30 last week (which makes it 15 years since being diagnosed with type 1 diabetes) and 2 days later he may have had a heart attack.  He is out of the hospital now and his angioplasty was very good and showed a healthy heart.  They went from saying heart attack to almost heart attack.  This made his blood sugars go to over 650.  Sugars are better now and he seems fine, but I'm just wondering what could have possibly caused this and what I need to watch for in the future.  We thought he was doing very well with his diabetic control, but while in the hospital his A1C was 12.  What should it be?

[Auntino]

Hi. What is almost heart attack?  Get the angioplasty film from the hospital and bring it to a cardiologist.  If it shows some plaque buildup then he needs NOW to be on cholesterol lowering drugs called statins (i.e. Lipitor, Zocor, etc) to prevent further damage.  Actually, s a diabetic, he should be on them anyway because Type 1 diabetics are notorious for high cholesterol and messing up arteries big and small.  I had minimal (3% plaque buildup 2 yrs ago and within a year cloed 1 artery and had a heart attack). Take that as a sign that he needs to get on this now.  Then have his eyes checked with a good opthomologist who will dialate his eyes and check the vessels.  I don't want to scare you but he is at this stage in the disease where issues start creeping up andthe way to avoid them is to be proactive and yes, get his a1c down to at least 7.  I believe the new goal is 6.5 but 7 would be much better than 12.

[T1DSydney]

I just want to support what the other two posters have said.  Remember, an A1c generally reflects the average blood sugar over the past three months.  An A1c of 12% is way too high.  He would generally feel lousy with a blood sugar out of range the majority of the time.  He should work directly with his endo to get a plan together that works for him. The first step is to test often and record the numbers so he and his doctor can get an accurate picture of where those highs appear.  He should keep a running log that details what he eats, blood sugars, exercise/activity etc.  Once he has an idea of what is actually going on, he can work with his doctor to improve his sugars.

[clarky99]

An A1C of 12% is quite high.  Diabetics shoudl set 7% as their target A1C level.  This translates into an average blood sugar of 170.  An A1C of 12% equals an average blood sugar of 345, which is far too high.

Look here for a breakdown.

http://clinical.diabetesjournals.org/cgi/content/full/24/1/9

Best of luck.

[JDRF-VOL-SG]

I agree with the two postings commenting on this very high a1c. Yes, this means his glucose has AVERAGED very high for the past 3 months. Which means that his control probably has not been as good as you thought -- and maybe not good for quite a long time. Long-time high glucose levels damage small blood vessels that feed major organs, and this can cause damage to those organs. Tightening up his glucose control indeed should be his primary goal. This will help not only his heart, but also his kidneys and eyes and other organs. Even though it is suggested to keep an a1c of 7 to prevent complications, many diabetics are actually now able to keep their a1c levels at around 6 with little effort.

[JDRF-VOL-RL]

Hi, hawkfan.  I'm not a medical professional, just the parent of a kid with diabetes.  Major health problems cause blood sugars to rise dramatically, even in non-diabetics.  There is something about the stress that the problem puts on the body that changes the body's ability to absorb that blood glocose.  A heart attack can certainly be considered a major health issue.  The high a1c could be a result of his body coming to the point of heart attack over the past few months, building up because of the stress on the system.  Verify with his endo, but I don't necessarily think that anything is that out of whack.  Good luck, and I hope he fully recovers soon.