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Heart disease is the leading cause of death in men and women. One in every four deaths in the United States occurs due to heart disease. That’s 610,000 deaths every year! And close to 10% of the US population has diabetes. Diabetes and heart disease, the two most dangerous health conditions, are related. People with diabetes are two to four times at a greater risk of dying from a heart disease than non-diabetics. This creates a terrifying scenario.
Type 2 diabetes begins with a phenomenon called insulin resistance. In this condition, the cells do not respond to insulin the way they should. Insulin is produced by the pancreas in response to high blood glucose. This insulin “pushes” the glucose into the cells. For the insulin to push the glucose into a cell, the cell should respond to its activity. But if the cell fails to recognize the presence of insulin or its efforts to push the glucose inside the cell, the glucose remains in the blood. This resistance to insulin is what leads to type 2 diabetes.
When there is insulin resistance, the body produces certain substances that cause blood clots. If these blood clots accumulate within the arteries that supply blood to the heart muscles, the blood flow is impaired. As a result, the heart muscles do not get enough oxygen and nutrients. Under such circumstances, the heart muscles may weaken leading to heart failure. This explains the connection between diabetes and heart disease.
Another reason for an increased risk of heart disease in people with diabetes is coronary atherosclerosis. Atherosclerosis is a condition in which plaques build up inside arteries and block blood flow. Atherosclerosis seems to develop faster in diabetics, due to the presence of risk factors like high blood pressure, high levels of blood sugar and high amounts of certain kinds of fats as well as cholesterol in their body.
Obesity and low levels of physical activity are other risk factors for heart disease. Obesity is a condition that can have a far-reaching impact on glucose metabolism, insulin sensitivity and the way in which body utilizes fats.
Type 2 diabetes is increasingly being recognized as a disease of continuous low-grade inflammation, or an inflammatory disorder. Inflammation may also start a chain reaction of highly complex metabolic processes that may increase the risks of heart disease.
Some people who suffer from diabetes and heart disease do not experience any signs or symptoms. This is referred to as “silent” heart disease. Oftentimes, diabetics suffer from neuropathy and therefore have impaired pain experience. This explains why such individuals do not feel any chest pain. When symptoms are present, they depend upon the type of heart condition the person suffers from – coronary heart disease, heart failure or diabetic cardiomyopathy.
Angina, a severe pain or discomfort in the chest, is the most common and prominent symptom. It feels like someone is squeezing your chest. Patients could also feel pain in the shoulders, arms, neck, jaw, and back. Angina pain may also be similar to pain caused due to indigestion. The pain worsens with activity and goes away when you are at rest.
Other symptoms of CHD may be nausea, fatigue, sweating, shortness of breath, feeling light-headed and weakness. Angina is a symptom of a possible heart attack and should always be taken seriously. If you think you are suffering from angina, let your doctor know. He or she may want to run a few tests on you to be sure if this pain is due to heart disease or due to some other reason.
A heart attack can feel the same as angina. A key difference is that in a heart attack the discomfort and pain persists for a longer duration and you do not feel any better even if you rest.
Common symptoms of heart failure are:
• Shortness of breath
• Swelling in the ankles, legs, feet, abdomen and veins in the neck
The symptoms worsen with progressive weakening of heart.
The term “myopathy” means a disease of the muscles. In this case, cardiomyopathy refers to problems concerning the muscles of the heart. Heart muscles can become enlarged, rigid and thick. Due to progressive thickening, the muscles of the heart lose their flexibility and the heart, in turn, becomes weak. As a result, the heart fails to pump enough blood to all parts of the body. It also isn’t able to maintain its regular beating rhythm. This leads to arrhythmias (irregular heartbeats) and eventually, heart failure.
Diabetic cardiomyopathy is usually symptomless in the early stages. Later, symptoms like shortness of breath, fatigue, swelling of the legs and feet and severe cough that fails to resolve easily, can be experienced.
Diagnosis of a heart disease is reached from your signs and symptoms, medical and family histories, physical examination and certain tests. Measurement of blood pressure and blood tests for detecting levels of triglycerides, cholesterol, sugar and proteins may help in diagnosis, with abnormal levels of these indicating an elevated risk for heart disease. A special blood test detects a hormone called brain natriuretic peptide (BNP). This hormone is made by your heart, and in the case of heart failure, its levels in the blood increase.
A chest X-ray examination can detect physical abnormalities in the heart and can reveal signs of a heart failure. A stress test helps doctors find out how well your heart is beating and is pumping blood. In this test, you are asked to run or walk on a treadmill or pedal a stationary bicycle. Various electrodes measure your heartbeats and provide information on how your heart behaves in a “stressed” environment.
Diabetic heart disease can be treated by a combination of lifestyle changes, medicine and medical procedures. The key to treating heart disease is to control your diabetes along with other risk factors like elevated blood pressure and high blood cholesterol levels. Reducing symptoms of heart disease (like angina), preventing complications of heart disease (like a heart attack), and repairing the damage to the heart and coronary artery are all objectives of treating diabetes and heart disease.
A healthy diet should be followed that includes a variety of vegetables and fruits, includes whole grains, protein-rich foods (lean meats, seafood), and nuts. The diet should be low in sodium, sugars and refined grains. All kinds of processed foods should be avoided as much as possible.
Since obesity is a major risk factor for diabetes and diabetic heart disease, you should endeavor to maintain a normal weight. Follow a disciplined weight loss plan that includes eating healthy and exercising.
You need to quit smoking, if you do smoke, as smoking is also an important risk factor in diabetic heart disease. Learn to manage your stress effectively as emotional triggers like anger can initiate a heart attack.
Medical procedures will depend upon the type of heart disease you have. Coronary angioplasty (“stenting”) and coronary artery bypass grafting (CABG) help improve blood flow to your heart and are recommended for coronary artery disease. CABG involves creating a bypass from the blocked artery, by grafting an alternative vessel for supplying blood to the heart.
If you have heart failure, your doctor may suggest cardiac resynchronization therapy (CRT) or an implantable cardioverter defibrillator (ICD.) CRT, or “pacemaker” is a small device implanted into your heart that regulates normal heart rhythm. ICD is a device similar in function to a pacemaker and is implanted just beneath the skin of the chest or abdomen.
The goals of preventing diabetes and heart disease aren’t too different from those of treatment. You need to take efforts to control the risk factors can play an important role in preventing or delaying heart disease. Adopting a healthy lifestyle is the best way to prevent heart disease and any other complication of diabetes.
Following a healthy diet, maintaining a healthy weight, following a routine of physical activity, managing stress effectively and quitting smoking are all part of a healthy lifestyle that can help you prevent diabetes and heart disease. Medications to control blood sugar levels, high blood pressure and abnormal levels of triglycerides and cholesterol will help in preventing these risk factors from causing heart disease.
The danger of a heart disease is real and far greater in diabetics than a non-diabetic person. Many risk factors make diabetics susceptible to health complications concerning this important organ. By managing diabetes and the other risk factors associated with it, you can prevent heart disease and keep your heart healthy.