Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute, Mumbai shares how to protect one’s heart when one has diabetes
Worldwide statistics suggests that at least 68 per cent of people aged 65 or older with diabetes die from some form of heart disease. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease.
So, what is the connection between diabetes and heart disease and why do diabetic patients normally suffer from a heart disease?
Diabetes is a major risk factor for not only developing heart disease, but also for developing atherosclerosis (hardening of the arteries) in the major vascular trees of the body including the brain, kidney, legs, eyes, etc. Diabetics have 2 to 3 times higher risk of developing heart disease as compared to nondiabetics.
The link
Diabetes and cardiovascular diseases often appear as the two sides of a coin: on one side, diabetes mellitus has been rated as an equivalent of coronary heart disease, that is if you have diabetes and have never had a heart attack, you are at the same risk for cardiovascular complications as a person with no diabetes but who previously has had a heart attack. And conversely, many patients with established coronary heart disease suffer from diabetes.
Multifactorial reasons
The reason why diabetics suffer from heart disease appear to be multifactorial. The high glucose levels in diabetes impair the ability of the blood vessels to expand leading to abnormal narrowing of the arteries as well as swelling in the vessel wall. Also, there is increased tendency for plaques (deposits along the vessel wall) to rupture. It can also lead to abnormal changes in the structure and function of platelets (tiny blood cells that help your body form clots to stop bleeding) leading to formation of blood clots and eventually resulting in a heart attack. Further, diabetes increases triglycerides and LDL (bad) cholesterol which aggravates the process of atherosclerosis leading to coronary heart disease.
Diabetics can also suffer from a type of heart disease known as cardiomyopathy, in which the heart becomes flabby and enlarged and weak, manifesting as heart failure.
Progression of heart disease in diabetics can be stopped or slowed down by strict control of diabetes mellitus. This is possible by adopting or intensifying healthy lifestyle changes. Let’s see how.
1. Eat a heart healthy diet:
What we eat plays a crucial role in maintaining our heart health. A well balanced and healthy diet can help in reducing your risk of developing diabetes induced coronary heart disease.
Consume a diet high in whole-grain fiber, lean proteins and colorful fruits and vegetables, legumes and pulses, low fat dietary products, fish and poultry without skin. Avoid overconsumption of instant and packaged foods, junk food, aerated drinks, sugar and salt.
2. Regular exercise is a must:
Exercise both aerobic and resistance is helpful in lowering blood glucose levels and increasing insulin sensitivity. A regular exercise plan is 30 mins a day for at least five days in a week. Aerobic exercises include fast walking, cycling, swimming etc and resistance exercises include light dumbbells, crunches, planks etc.
3. Reduce weight:
Weight reduction helps in diabetes control. A healthy diet pattern and regular exercise programme helps in weight reduction.
4. Abstinence from active and passive smoking:
Smoking can be cause of type 2 diabetes. Those who smoke have 30 to 40 per cent higher risk of developing diabetes. Smoking and diabetes both are very high-risk factors for heart disease and stroke.
5. Bring down your stress:
Stress in any form releases some type of hormones because of fight or flight response phenomenon. These hormones can lead to higher blood glucose level. Stress diabetes is a common condition in many patients during the period of illness or surgery.
6. Regular screening is important:
Persons within the age group of 40 to 70 should have screening for diabetes at least once in three years. Those who are at higher risk should have screening at more frequent intervals.
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