WHAT CAUSES HEART DISEASE?

The most common cause of heart disease, in a person with diabetes is due to "atherosclerosis" or hardening of arteries. The cholesterol plaques, which deposit along blood vessels over a long period of time, gradually block the blood vessels, limiting the oxygen & nutrition supplied to the heart. In an uncontrolled Diabetic, high levels of blood sugar has been shown to speed up the artery clogging that leads to a heart attack eventually. As a matter of fact, not only the blood vessels of the heart, the same process can happen in other parts of the body especially, in the eyes & kidneys leading to serious conditions like blindness & kidney failure.

When a Diabetic with clogged blood vessels supplying the heart, develop a heart attack, most often it is a "silent attack" as they may not develop the intense pain, sweating, palpitations (awareness of one's own heart beat) and other associated symptoms like a non diabetic individual because of nerve damage. Hence, the vague symptoms may be ignored or passed off as indigestion or a stomach upset.

This can gradually lead up to the stage of heart failure with fluid built up in lungs and fluid retention in other parts of the body causing a swelling of legs often due to an inability of the heart to pump blood sufficiently.

What other risk factors contribute?

Many other conditions typically found in people with type 2 diabetes can contribute to heart disease. They are,

• Obesity -  It's a major risk factor because, obesity itself decreases insulin response and often, people with obesity & diabetes have other risk factors like high blood pressure, a sedentary life style, and high cholesterol. 
  How do you know whether you are obese or over weight? Simple! Get your height in meters and weight in kilograms. If you divide your weight by (height)2 the value you get is called 'Body Mass Index' the normal of which is 18.5-24.9. If the BMI is between 25-29.9, it is considered over weight and when the BMI reaches more than 30, it's called obesity! An obese diabetic is a candidate for heart attacks earlier than predicted for age and sex.

• Lack  of  Physical  activity - Physical inactivity is a major risk factor, which can be modified easily. Exercising and losing weight will not only help to manage diabetes, but also reduce blood cholesterol and reduce the risk of heart attacks & strokes. Regular aerobic exercises, if you keep to a schedule would help to burn the calories thereby losing weight, strengthen the cardiovascular system and reduce blood glucose as well as cholesterol.

• High  Blood  Pressure - Is a known risk factor for heart disease as well as for stroke. When a diabetic has high Blood Pressure, their risk of developing a heart attack doubles. High blood pressure is often diagnosed late as it gives rise to very few or no symptoms at all.

• High  Cholesterol - Diabetic patients commonly have high levels of triglycerides and LDL cholesterol which contributes to the clogging of blood vessels & blocking them.

• Smoking - Promotes atherosclerosis and blocks blood vessels supplying heart, brain, kidney and lower limbs. It also raises blood pressure. Smoking and Diabetes are a lethal combination.

As high blood pressure, high cholesterol & obesity usually accompanies diabetes, this combination of risk factors can contribute to heart attacks earlier than the expected ages for an individual. In addition, being over 40 years of age, being a male and having a family history of diabetes can add to your risks for developing heart disease. Once a person with diabetes has had a heart attack, the risks of further heart problems are sky-high.

CAN GOOD CONTROL OF DIABETES PREVENT HEART DISEASE?

If you have diabetes, you need to work harder than most others to prevent heart disease. Early diagnosis and learning how to monitor and control the disease are important aspects in the long run. You should make all efforts to get rid of modifiable risk factors like obesity, smoking, lack of exercise and high cholesterol.

Tight blood sugar control is critical to reduce the risk of heart disease as well as other complications. The best indicator of your blood sugar control would be the HbA1C level as it reveals how well a person's blood sugar is controlled over the last 03 months.

If you have high blood pressure, it will be an added benefit on the heart to control it with drugs, exercise, cessation of smoking, healthy diet etc. All people with diabetes would benefit from a Blood Pressure of 130/80mmHg or even lower.
People with diabetes must make an extra effort to keep their cholesterol level low. They should target for a level lower than the goal for healthy non-diabetics. It is safe for a diabetic patient to aim for a bad cholesterol level of 100 mg/dl.

So the key points to prevent or delay the onset of diabetes related heart disease are,

• Healthy eating habits. Basic guidelines for eating right comprises of "eating a balanced meal of starchy carbohydrates, proteins and lipids, with low salt, low fat and high fiber content" Stick to a regular meal plan. Avoid refined sugars and excessive consumption of alcohol.
   

• Control your blood pressure if it is high. Most often benefits of drugs outweigh the side effects.
   
• Keep your cholesterol level low. Try diet control & exercise first. Medicines too can help.
   
• Be active- stick to aerobic exercises as it could be a life saving exercise at the end.
   
• Control your weight for each pound you put on, the burden is not only on your feet but also on your heart!
   
• Quit smoking -Needless to mention the rewards in life when you stop smoking.

There is no cure for diabetes (at least, at present!) but with careful monitoring and commitment, diabetics can avoid complications & enjoy a long, productive life. It's time to take diabetes to your heart!