Diabetes is caused when the blood glucose levels in the body is higher than normal. The body breaks the food into glucose and carries it to all the cells which are converted to energy using insulin (hormone). There are two types of diabetes, namely, type 1 – when the body doesn’t make enough insulin and type 2- when body doesn’t use insulin properly.
The higher the person’s blood sugar level is the higher the chances of developing heart diseases. Compared to people who do not have diabetes, people having diabetes are at an elevated risk of heart disease even at young age.
Diabetes affects heart disease risk in three major ways. Just like smoking, hypertension and high cholesterol, diabetes itself is a serious risk factor for heart disease. People with T2DM are at same risk of suffering a cardiac arrest or heart attack like those who have a history of heart attack.
Diabetes, when combined with other risk factors like obesity, overweight and metabolic syndrome, causes harmful physical changes to the heart. People with a history of cardiac disease treatment like bypass grafting, angioplasty etc tend to have less success if the blood sugar level is uncontrolled.
Diabetes increases the risk of heart diseases as it raises the cholesterol levels in the blood and hardens the arteries, a condition known as atherosclerosis. Moreover, diabetics are overweight which furthermore worsens it and raises the risk to heart diseases.
Coronary Heart Disease: With raised cholesterol levels in diabetics, plaque builds up inside the coronary arteries that supplies oxygen rich blood to the heart. This plaque narrows the coronary arteries and reduces the blood flow to the heart muscles and can lead to clot formation. This leads to blockage of blood flow causing chest pain, irregular heartbeats, heart attack and even death.
Heart Failure: When the heart is unable to pump blood to meet the body’s requirements, it puts load on heart muscles leading to heart failure. This doesn’t mean that the heart has stopped working but its pumping ability has reduced. This is a serious medical condition that can make you easily tired, limit your activities and weaken the heart muscles with time.
Cardiomyopathy: This disease damages the structure and functioning of the heart in those who have diabetes. The disease can lead to heart failure and abnormal beat. The various causes of heart disease due to diabetes include Atherosclerosis, where plaque builds up inside the arteries and progresses with age. High Blood Pressure, smoking, uncontrolled diabetes and high cholesterol levels in the blood damage the inner layer of the coronary arteries. Metabolic Syndrome, which is a group of risk factors that raises CHD and T2DM. Obesity causes change in body fat and the way body utilises insulin. Chronic inflammation raises the risk of CHD and heart diseases
Some of the controllable risk factors are unhealthy cholesterol levels in the blood – high levels of LDL and low levels of HDL; hypertension – high levels of blood pressure (above 140/90mm Hg); smoking – damages and tightens the blood vessels, diminishing the blood supply to all parts of the body; obesity — leads to diabetes and other heart diseases; lack of physical activity; following an unhealthy diet and stress.
The risk factors that cannot be controlled are increasing age which raises the risk of heart diseases; gender – at younger age men are more prone to heart diseases than women; family history of heart disease and preeclampsia.
The main goal to treat heart disease due to diabetes includes controlling diabetes and high blood pressure and cholesterol; relieving chest pain and heart disease symptom; preventing or delaying heart disease complications, and repairing heart and coronary artery damage.
Treatment involves lifestyle changes, medicines and surgical procedures. One must follow healthy balanced diet, maintaining a healthy weight, be physically active, quit smoking and manage stress. Medicines should be taken for treatment for heart failure, blood sugar, blood pressure and cholesterol control.
The writer is an associate director – interventional cardiology, Max Super Speciality Hospital, Shalimar Bagh