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Explained: The diabetes and heart disease link

By Apollo 24/7, Published on- 18 November 2020

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According to the World Health Organization, heart disease is responsible for the maximum number of global deaths. And the likelihood of having a stroke or heart disease is twice in people with diabetes when compared to the ones without it. Diabetic people have high blood sugar (glucose) levels which over time may damage the heart and other organs. Additionally, most people with diabetes may have other conditions like hypertension, which increases the risk of heart disease. By understanding the link between diabetes and heart disease, one can make the necessary lifestyle changes that can improve heart health and make diabetes management more effective.

Why does diabetes increase the risk of heart disease?

Diabetes affects the blood vessels that carry blood to and from the heart. Diabetes impedes the flow of oxygen and nutrients in the blood thereby affecting the cardiovascular system in several ways, causing a heart attack, heart failure, and stroke.
  • In people with high blood sugar, the glucose attaches to the haemoglobin and disrupts the proper distribution of oxygen throughout the body.
  • Diabetes leads to the formation of clumps of LDL (“bad”) cholesterol, leading to the build-up of fatty deposits.
  • Diabetes causes fatty acids to be produced, that can destroy proteins in the blood vessels.
  • Diabetes causes inflammation and blockage of blood vessels, a condition called atherosclerosis, which in turn leads to heart problems.

Major conditions in diabetes patients that cause heart problems

Diabetes patients can have other conditions that significantly increase the risk of developing heart disease:
  • Hypertension (High blood pressure) - Hypertension is a condition that increases the force of blood pushing against the walls of the arteries (blood vessels). When the blood pressure is consistently high, it causes damage to the artery walls. Having both high blood pressure and diabetes can have a damaging effect on the heart.
  • High cholesterol - Elevated levels of LDL cholesterol in the bloodstream can lead to the formation of plaque on the damaged artery walls. Plaque refers to fatty deposits composed of cholesterol and fatty substances. These plaques can harden over time, causing the narrowing of the arteries.
  • High triglycerides – Triglycerides are a type of fat in the blood. Increased triglycerides, combined with low HDL or “good” cholesterol, or high LDL or “bad” cholesterol, are associated with hardening of the arteries or thickening of the artery walls.
People with diabetes are also at risk of heart failure where the heart cannot pump blood efficiently. This can cause edema or swelling in the legs/ankles and build-up of fluid in the lungs, causing breathing difficulties.

Heart care in people with diabetes

Taking care of the heart is important for people living with diabetes. Lifestyle changes not only help to manage diabetes but can also lower the risk of heart diseases.

  • Following a healthy diet – Include fresh fruits and vegetables, whole grains, and lean protein. People with diabetes must limit or avoid processed foods and foods rich in trans-fats.
  • Maintaining a healthy weight - Even a modest weight loss of 5% to 7% of the total body weight is shown to improve blood pressure, blood cholesterol, and blood sugar levels in diabetic people.
  • Being physically active - Physical activity is shown to increase insulin sensitivity, which helps to keep blood sugar levels stable.
  • Managing the ABCs – Knowing and controlling the ABCs of diabetes, as recommended by the American Diabetes Association, are essential to staying healthy
    • A, for A1c test. Haemoglobin A1C (HbA1c) test is a blood test to measure the average blood sugar levels over the last 3 months.  Patients with diabetes should aim to keep the A1c levels less than 7%.
    • B, for Blood pressure. Doctors recommend that people with diabetes must measure their blood pressure often, with a goal of keeping it below 140/90 mmHg.
    • C, for Cholesterol. Since patients with diabetes have an increased risk of cholesterol-related problems, the goal should be to lower LDL cholesterol (bad) and increase HDL cholesterol (good) levels.
    • S, for stopping Smoking. Nicotine in tobacco reduces the oxygen supply to the heart, raises blood pressure, increases heart rate, and harms the blood vessels.
  • Managing stress - Stress can increase blood pressure and can lead to overeating and excessive alcohol intake. One should try meditating or deep breathing and get some physical activity to reduce stress levels.

Conclusion

According to the American Heart Association, diabetes is considered one of the seven major risk factors for heart diseases, which can be controlled. Individuals with diabetes, combined with one or more of the above risk factors are at even greater risk for developing a heart attack or stroke. Knowing the risk factors, periodic testing, and managing their ABCs is crucial for diabetics. By making lifestyle modifications, people with diabetes may prevent or delay heart-related diseases and complications.
If you have any queries related to diabetes, you can speak to an endocrinologist or a diabetologist. And for any questions on heart health, you can consult a cardiologist.

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