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Heart Disease & Diabetes

How common is heart disease in patients with diabetes?

Heart disease is very common among patients with diabetes. Indeed, it is the most common cause of death in patients with type 2 diabetes. Especially in patients with high blood pressure and cholesterol along with diabetes, heart disease is more common. Heart disease can be due to various reasons in diabetes. It could be due to partial or complete blockage of the coronary arteries (arteries that supply the heart) and is called coronary heart disease. It could also be due to poor pumping of the heart with or without much block in the coronary arteries. This is called heart failure.

What exactly is coronary heart disease?

Just like other organs, the heart is supplied by small arteries called coronary artery. In patients with diabetes, deposits of cholesterol mixed with other components (called plaques) can form inside the wall of the coronary artery. This will narrow the coronary artery and reduce the blood supply to the heart. This is coronary artery disease. When the block of coronary artery happens suddenly, we call it a heart attack.

What are the symptoms of heart disease?

As the coronary artery progressively narrows, the heart is starved of oxygen (this is called ischemia), the patient experiences a heaviness of the chest when he exerts himself by climbing stairs or walking. This discomfort is called angina. As the vessel progressively narrows, there will be pain at rest. If there is a heart attack, the patient may have a severe central chest pain that may move to the left arm or neck and associated with sweating. Breathlessness, leg swelling, neck pain and falling unconscious are all symptoms of heart disease in diabetes.

What are the risk factors for heart disease?

Your chances of getting heart disease or having a stroke are even higher if

  • one or more members of your family had a heart attack at an early age—before age 55 for men or 65 for women
  • you carry extra weight around your waist
  • your LDL (bad) cholesterol or triglycerides, another type of blood fat, are high
  • your HDL (good) cholesterol is low
  • you have high blood pressure
  • you smoke
  • blood sugars are not in target

How do I know whether I have heart disease?

If you have symptoms of heart disease mentioned above, it is high time that you consult a doctor and get yourself checked. If you have risk factors, you can meet your doctor and get a heart check-up done. Whether you have risk factors or not, annual ECG can help you diagnose heart disease.

What tests do doctors use to diagnose heart disease?

The ECG is a simple but valuable tool to diagnose heart disease. Patients can be put through an exercise tolerance test. The heart will be stressed by walking or running on a treadmill and continuous ECG will be recorded during this time. This test will help to understand if there is any area in the heart which is deprived of blood supply during exercise.

The doctor may use an echocardiogram to exclude any changes in the pumping of the heart and also to assess the function of the heart.

For patients with a high degree of suspicion for heart disease, an angiogram will be done to visualize the blood vessels directly. Nuclear medicine tests like stress thallium scans and coronary CT are important tests in specific circumstances.

How can I prevent heart disease related to diabetes?

You can reduce the risk of heart disease related to diabetes by taking care of ABC. A stands for HbA1c that measure sugar control, B stands for blood pressure and C for cholesterol. You can take these steps to keep your heart and blood vessels healthy:

  • Follow a “heart-healthy” meal plan that your doctor or a dietitian designs for you.
  • Be physically active for 30 to 60 minutes most days. For example, go for a walk every day.
  • Take your medicines as directed and keep taking them, even after you’ve reached your goals.
  • If you smoke, quit.
  • Ask your doctor if you should take aspirin to prevent heart disease or stroke.