Diabetes and heart disease have a strong relationship. According to a survey in 2012 by the National Heart Association, it was found that 65% of people with diabetes die due to cardiac diseases or stroke. Heart disease itself is a serious condition taking the lives of men and women at a much greater pace than other common diseases. In diabetic patients, the risk of death due to heart failure exceeds two-fold as compared to those without diabetes. Any type of diabetes results in an increased risk of heart disease but the most commonly affected patients are those with type-2 diabetes. According to a global survey, heart disease is the most common cause of death in people with type-2 diabetes. (1)
The Mechanism by which Diabetes affects your Heart:
The main underlying mechanism by which diabetes affects your heart is that the high glucose levels in the blood lead to damage to the nerves and blood vessels supplying the heart. Diabetics patients have other comorbidities that can further worsen their heart health. These include the following:
Diabetic patients are at increased risk of hypertension that can damage the arteries due to the force of blood in them. A combination of high blood glucose levels and high blood pressure leads to more damage to the vessels supplying the heart.
Diabetic patients with high bad cholesterol levels (i.e., LDL) can worsen the vessel walls by forming plaques in them. In addition to this, low levels of good cholesterol (i.e., HDL) and high levels of triglycerides can lead to thickening and stiffening of blood vessels leading to an increased risk of heart diseases such as cardiac arrest that can cause sudden death.
Diabetic patients are at increased risk of heart failure in which the heart is unable to pump enough blood to the body parts. It leads to increased pooling of blood in the vessels and fluid moves out of the vessels leading to swollen legs and fluid build-up in the lungs. Heart failure can lead to cardio-pulmonary arrest, which is a significant cause of death among diabetic patients and the general population as well. (2)
How we can find out that the patient is having a heart problem?
You should know the symptoms of heart disease in order to check whether your diabetes is affecting your heart or not. The symptoms include the following:
- Dyspnea (shortness of breath)
- Dizziness and fainting
- Increased sweating without any apparent triggering factor
- Pain in the chest that can radiate to jaws, shoulder, and left arm.
- A feeling of heavy pressure on the chest
How you can prevent heart disease in diabetics?
To prevent the risk of heart disease in people with diabetes, here are some prescribed measures that can significantly lessen the risk of heart disease. These include the following:
- Keep your sugar levels within normal or near-normal limits.
- Blood pressure control and the target should be less than 130/85 for diabetics. Both pharmacological and non-pharmacological antihypertensives can help.
- Keep you within your normal BMI range, if obese, reduce weight in healthy ways.
- Regular physical activity especially cardio exercises.
- Healthy eating options and eating habits
- Decrease amount of physical and mental stress
- Quit smoking (4)
References:
- Schmidt AM. Diabetes Mellitus and Cardiovascular Disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2019 Apr;39(4):558–68.
- Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015 Oct 10;6(13):1246–58.
- Rajbhandari J, Fernandez CJ, Agarwal M, Yeap BXY, Pappachan JM. Diabetic heart disease: A clinical update. World J Diabetes. 2021 Apr 15;12(4):383–406.
4. Newman JD, Schwartzbard AZ, Weintraub HS, Goldberg IJ, Berger JS. Primary Prevention of Cardiovascular Disease in Diabetes Mellitus. J Am Coll Cardiol. 2017 Aug 15;70(7):883–93.