How diabetes affects heart health

Diabetes increases your risk of silent heart attacks and hence needs to be kept in control

blood glucose monitorDid you know that people with diabetes are 2 – 4 times more likely to have a heart attack or stroke than those without the disease?

Heart attacks do not always have obvious symptoms such as sharp chest pain and breathlessness and there are some heart attacks that go entirely unnoticed.

A silent heart attack is one in which the person does not feel chest pain or any other symptom.Silent heart attacks can happen to anyone, but people with diabetes are more predisposed to these because of nerve damage [autonomic neuropathy] caused by poorly controlled diabetes. 25 – 30 per cent of heart attacks in diabetics are silent.

In the case of a silent heart attack, the patient is not aware of the attack and hence, due to lack of knowledge, there is a high risk of damage to the heart since treatment is either delayed or not received at all. Research shows that twice as many people die from a silent heart attack than those who experience chest pain.

Uncontrolled diabetes leads to significant cardiac health risk because of changes in the blood vessels produced by hyperglycaemia [high blood sugar], changes in blood coagulation properties, and changes in the plaques that form in the blood vessel.

These could mean a silent heart attack:

  • Extreme weakness or anxiety
  • Shortness of breath
  • Sweating or light-headedness
  • Nausea or indigestion
  • Discomfort or mild pain in the chest, back, arms, neck or stomach.

It is common for most to ignore these symptoms or pass them off as vague dizziness or weakness. If you experience any of the above symptoms, seek medical attention immediately.

The best way to identify silent heart disease is through careful study of medical history, ECG [electrocardiogram], stress test or echocardiogram [ultrasound of the heart] and testing blood for cardiac enzymes.

Along with uncontrolled diabetes, high blood pressure, high blood cholesterol, smoking, obesity and a sedentary lifestyle, significantly increase the chance of a silent heart attack.

Regular screening for cholesterol and blood pressure, electrocardiogram [ECG] tests during rest and treadmill along with regular blood glucose monitoring can reduce the risk factors for such attacks. Blood glucose can be controlled with the help of medicines and insulin.

Research shows that making certain healthy lifestyle changes can also minimise the risk of heart disease. Healthy diet, regular physical activity, weight loss, smoking cessation, limited alcohol consumption and proper medication go a long way in controlling diabetes and improving heart health. Heart and vascular disease go hand-in-hand with diabetes.

However, by making healthy lifestyle choices and by following your doctor’s advice, even diabetics can enjoy a healthy and long life.

Dr Manoj Chawla, MBBS, D Diabetology [Bom], is a consultant diabetologist in Mumbai. He was also the member of the managing committee of Indian Medical Association, BWS branch.


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