Silent killer

Tags: Knowledge

For a diabetic, the focus is invariably on the highs and lows of blood sugar levels, but close attention should be paid to heart and blood vessels, which otherwise could be doubly deadly

Very often we meet people suffering from diabetes and externally they look perfectly normal. There are no signs or symptoms that tell you that the person is suffering, but internally the disease is slowly eating them. The liver, kidneys, eyes and — most importantly — the heart bear the brunt of this disease.

The WHO estimates that India will have the dubious distinction of leading the world in diabetes. According to my estimate, we have already secured the top position as far as low awareness and ignorance of diabetes is concerned. For a diabetic, the focus is invariably on the highs and lows of blood sugar level. But besides blood sugar, close attention has to be paid to the heart and blood vessels.

Alarming figures

Nearly 70 per cent of people with diabetes aren’t aware that they’re at an increased risk of heart attack and stroke. In people with diabetes, heart disease often doesn’t offer clues, so diabetics may not seek medical care until noticeable symptoms and serious complications have occurred. In other words, a “silent” heart attack is not uncommon among diabetics.

According to statistics cardiovascular disease is a major complication of diabetes and the leading cause of early death among people with diabetes. Adult diabetics are two to four times more likely to have heart disease or suffer a stroke than people without diabetes and about 65 per cent people with diabetes die from heart disease and stroke. And people think that foot or leg amputation and blindness are the biggest threats of diabetes!

Diabetes can damage your blood vessels, including the arteries that supply blood to your brain and heart. This damage makes it easier for fatty deposits (plaques) to form in the arteries.

The fluctuations in sugar levels and resultant hardening of arteries can slowly take the person towards major complications. Studies have shown that diabetics tend to have a different heart anatomy and co-morbidities (other existing health conditions), their arteries are smaller and often twisted, with longer gash and hence the disease spreads at rapid rate leading to treatment failure. Further, it is a known fact that diabetics take longer time to heal in case of any disease or ailment. Hence it is important for diabetics to work with their healthcare practitioners to help lower the risk of a heart attack and identify the problem before it worsens

Take action!

Although the statistics may sound alarming, it does not mean that you’re destined to face a heart attack or stroke if you have diabetes. Nevertheless, it is always better to take preventive measures to avoid any unpleasant surprises in the future.

The National Diabetic Educa­tion Programme has come up with the ABC’s of managing diabetes. The ABC treatment goals are optimal management of A1C (a measure of average blood glucose) less than 7 per cent, blood pressure less than 130/80 mmHg, and cholesterol — LDL less than 100 mg/dl

Today there are several aids to successfully manage diabetes; the most common are the blood glucose meters and continuous glucose monitoring (CGM) systems. CGM is a way to measure glucose levels in real time throughout the day and night. Insulin pumps are being more commonly used because of their unique ability to continuously infuse insulin, closely mimicking the behaviour of physiological secretion from normal pancreas.

Insulin pump therapy is used by people of all ages. Many studies have shown improved glucose management outcomes for those using insulin pumps. It does seem to allow for more flexibility in lifestyle and the potential to even out the wide blood sugar fluctuations that are often experienced when injecting insulin. These will aid diabetics to manage their A1C at the desired level.

‘Resolute’ treatment

If you are diagnosed with a high risk of cardio vascular disease, then angioplasty is an effective and quick treatment to treat blocked arteries. Today the medical field has made huge progress. Medtronic’s Resolute Integrity is the only drug-eluting stent (DES) to be approved by the US Food and Drug Administration (FDA) for the treatment of coronary artery disease (CAD) patients who also have diabetes. The Resolute Integrity DES offers several notable benefits — it is exceptionally easy to navigate this stent through the coronary vasculature to the narrowed arterial segment that requires treatment, The stent also achieves an extended 180 day drug elution, thereby meeting the longer healing time may require for the diabetic patients and have shown excellent safety and lower restenosis rates in diabetic patients.

Diabetes and cardiovascular Diseases share an evil axis and the only way to control this is by understanding the complications and making healthy choices. After all we have only one life.

(The writer is senior consultant and chief cardiac, Max Balaji Hospital, New Delhi)

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