Diabetes and Heart Disease

There is no question that people with diabetes are more likely to have conditions that increase the risk of heart disease. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. Individuals with diabetes have a higher risk of developing coronary artery 00disease (CAD, caused by a narrowing or blocking of the blood vessels that go to the heart, heart attack or stroke than non-diabetic persons. People with diabetes also tend to develop heart disease at an earlier age than those without diabetes. Some common risk factors shared by diabetes and heart disease are physical inactivity, unhealthy diet, obesity, high blood pressure and cholesterol, low birth weight, smoking and stress.

In individuals without diabetes, inadequate blood flow to the heart muscle may cause a variety of signs and symptoms, such as chest pain or pressure, pounding heartbeat, shortness of breath, jaw or arm pain, and sweating. However, none of this heart-related symptoms may be present in a person with diabetes. This type of heart ailment known as ‘silent ischemia’ is a common feature among people with diabetes. The lack of symptoms may give one a false sense of good health and may prevent one from seeking medical care or treatment until serious complications have occurred. Regular screening and follow up visits with the diabetologist/physician can help one identify risk factors and heart problems before they worsen. Various tests can help assess heart function, such as an electrocardiogram (ECG). The early stages of CAD, which involves both functional and structural changes in the arteries, can be studied using sophisticated non-invasive techniques. These include carotid intimal medial thickness (IMT), endothelial dysfunction and arterial stiffness.

Key tips to prevent/control heart diseases in individuals with diabetes:

• High blood sugar can damage the blood vessels. Keeping blood sugar levels within optimal ranges [fasting blood glucose 90-130 mg/dL and 2 hr post prandial glucose below 180 mg/dl] can prevent or delay blood vessel damage.
• The best way to assess one’s long term diabetes control is by performing the hemoglobin A1 c (HbA1c), which measures average blood glucose over the past 3 months. The target HbA1c for preventing diabetes complications is <7%.

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• Hypertension or high blood pressure can lead to heart disease. Maintain your blood pressure at 130/80 mm/Hg.
• Increased blood cholesterol and triglycerides can also lead to heart problems. Maintain increased levels of good cholesterol (HDL) and decreased levels of bad cholesterol (LDL) <100 mg/dl, triglycerides < 150 mg/dl and total cholesterol < 200 mg/dl.
• Restrict intake of egg yolk, mutton, organ meats and fried & salty foods.
• Do regular exercise for a minimum of 150 minutes/week or in consultation with your physician or fitness consultant.
• Do not smoke or chew tobacco.
• Central or abdominal obesity means carrying extra weight around the waist. A waist measurement of more than 90 cms for men and more than 80 cms for women means one has abdominal obesity.