Even if your BLOOD GLUCOSE is controlled or normal,
you might be at the risk of HEART ATTACK & STROKE* (due to other risk factors)
How Diabetes Affects Your Heart
Diabetes and heart disease are interrelated. High blood sugar, over a period of time, may cause damage to blood vessels and the nerves that control the heart. People with diabetes are also vulnerable to develop conditions associated with higher risk for heart disease, such as:
- High blood pressure: A condition that tends to maximize the force of blood through your arteries, thereby increasing the risk of damaging artery walls. Having both high blood pressure and diabetes can greatly increase your risk for heart disease.
- High level of LDL(Low-density lipoprotein), or bad cholesterol in bloodstream. A high LDL level leads to a buildup of cholesterol in your arteries and raises your risk of developing heart disease or stroke,
- High triglycerides (a type of fat in your blood), and low HDL or good cholesterol. These two conditions can together contribute to hardening of the arteries, which again raises the chances of heart disease or sudden heart failure.
Other factors that can also raise your risk of diabetes and heart disease, includes:
- Being obese or overweight
- Lack of even minimum physical activity
- Eating saturated fat, trans and cholesterol, and sodium (salt) containing foods
- Too much consumption of alcohol
People with diabetes have higher risk of heart failure, a serious condition characterized by decreased ability of heart to pump blood. This insufficient pumping may cause swelling in legs and accumulation of fluid in the lungs, making it hard to breathe. Heart failure may worsen over time, therefore, early diagnosis and treatment is warranted for better prognosis.
What Causes Heart Disease in People With Diabetes?
Having diabetes or pre-diabetes means increased risk for heart disease, which may include heart failure, coronary heart disease (CHD), and diabetic cardiomyopathy among others.
Diabetes tend to cause heart disease in a person by causing hardening of the coronary arteries (referred to as atherosclerosis), which occurs due to cholesterol build-up in the blood vessels that supply nutrition and oxygen to the heart.
The cholesterol build-up is life-threatening in the view that plaques can break apart or rupture. When this happens, the body tries to repair the rupture by sending platelets to seal it up. But, due to the small size of the artery, the platelets end up blocking the flow of blood, thereby restricting the oxygen delivery and increasing the risk of a heart attack. The same mechanism may take place in the arteries across the body, increasing the chance of a stroke or lack of blood to the feet, hands, or arms.
People with diabetes are also vulnerable to higher risk of heart failure, a serious medical condition in which the heart couldn’t pump enough blood. This, in turn, may lead to fluid build-up in the lungs making it difficult for the patient to breathe. The similar fluid retention in other parts of the body (especially the legs) may also cause swelling.
What are Some Symptoms of a Heart Attack?
Diabetes increases heart attack risk as well as the risk of other heart-related conditions. And, unfortunately most of heart-related problems are silent killers as they don’t produce any clear symptoms or warning signs.
In general, those who are 60 or older, have diabetes, high blood pressure, high cholesterol or are overweight should always watch out for the risk of heart diseases. But, it doesn’t mean others can sit back and relax. Be it in any age group, every adult should make sure to get an annual complete body health-checkup done.
Listed here some common heart disease or heart attack symptoms that all should be aware of:
- Chest Discomfort is among the most common heart disease symptoms, which is characterized by tightness, pain, or pressure in your chest.
- Frequent heartburn, nausea, indigestion, stomach pain, or unexplained vomiting (especially, in women) warrants attention.
- Pain that spreads to the arm and radiates down the left side of the body is among the classic heart attack symptoms.
- Experiencing dizziness or lightheadedness associated with loss of balance or feeling faint for a moment at regular intervals may indicate an underlying heart disease.
- Throat or jaw pain accompanied with pain or pressure in the center of your chest could be a signal of a heart attack.
- Feeling fatigued or exhausted all the time without any specific reason needs medical advice. In addition, snoring like a gasping or choking, irregular heartbeat, breaking out in a cold sweat for no visible reason, and swollen legs need to be reported.
How is Heart Disease Treated in Those With Diabetes?
Any treatment program begins with precautions. And, the precautions in this case include eating a healthy diet, getting physically active, avoiding trans-fat and saturated fat completely, staying away from smoking and drinking, and most importantly, staying positive in life.
Talking about the heart disease treatment with diabetes, here are the alternatives your doctor may prescribe:
Aspirin Therapy: Diabetes medications for heart disease that treat both heart damage and lower blood glucose (blood sugar), cholesterol, and blood pressure, and cholesterol. If you are at the risk of heart attack, aspirin would be at your bedside table all the time as it is effective in reducing the risks of clots that can cause heart attacks and strokes. Aspirin helps in blood thinning and prevents the formation of blood clots, which may lead to a heart attack.
Diabetes medications for heart disease: Diabetes disease treatment is considered a priority in people having diabetes and heart disease risk. Recent researches show that newer antihyperglycemic medications (GLP-1 and SGLT-2 medications) are effective in both reducing blood glucose levels and preventing heart-related ailments.
High BP medication: If untreated, high BP may cause damage to blood vessels, the heart and other organs — ultimately leading to death.
Cholesterol medication: It is another essential medicine (statins) that people battling co-morbid diabetes and heart disease may need to keep a tab on cholesterol, in the view of its damaging effect on heart.
How Can Heart Disease Be Prevented in a Person With Diabetes?
Diabetes and heart disease prevention is all about some lifestyle changes and medication (if required). These simple yet effective changes can go a long way to help lower the risk for heart disease or prevent it from worsening, while managing diabetes simultaneously.
- A healthy diet is the key. Consume more vegetables, fresh fruits, lean protein, and whole grains. Avoid processed foods (such as fast foods, carbonated beverages, chips, and sweets. Stay hydrated by drinking more water.
- Healthy weight matters the most. Being obese or overweight tends to increase triglycerides and blood sugar levels. Maintain a healthy BMI (weight in kg) / height in m2) i.e. 18.5 – 24.9.
- Get active. At least 150 minutes per week of brisk walking or moderate exercising is enough for both diabetes prevention and heart disease prevention.
- Manage your ABCs:
- Get a regular average blood sugar (A1C) over 2 to 3 months
- Make sure your blood pressure is below 140/90 mm Hg
- Keep a check on cholesterol levels.
- Quit smoking or never start it. It will nip so many health problems in bud.
- Manage stress: Increased stress level is associated with high blood pressure. Try meditation or deep breathing or follow your doctor’s advice to manage stress.
Testing for Heart Disease and See Your Diabetes Educator
Diabetes education provided by a diabetes educator is effective in terms of managing diabetes and lower heart disease at the same time. Further, with effective advice on diabetes and heart disease risk you can better manage your blood glucose and cop with daily challenges of the disease.
Your diabetes educator will also help you mitigate the risks for developing complications and need of emergency hospital visits. For more information, you can always visit Making India Heart Strong website. It will help you with effective advice on diabetes and heart disease prevention and guide you to deal with emergency situation related to diabetes and heart disease.
Understand the risk of heart attack with increase in risk factors
An odds ratio (OR) is a measure of association between an exposure and an outcome. OR >1 indicates increased occurrence of event | OR <1 indicates decreased occurrence of event (for e.g., chances of developing heart attack and stroke is 2.9 times higher in smokers as compared to non smokers)
*Yusuf S, Hawken S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):937-52.
- https://www.webmd.com/diabetes/heart-blood-disease https://care.diabetesjournals.org/content/30/1/162#:~:text=Aspirin%20therapy%20(75%E2%80%93162%20mg,%2C%20dyslipidemia%2C%20or%20albuminuria).