Date:14/11/2008 URL: http://www.thehindu.com/2008/11/14/stories/2008111454500500.htm

Tamil Nadu

Diabetes and Heart – The Deadly Duo

The incidence of diabetes is constantly increasing in the past few years all over the world due to the changing lifestyle and increasing obesity among the public. India is going to be the world capital of diabetes by 2020 with maximum number of diabetic patients living in India.

Diabetes increases the risk of heart disease 2-4 fold compared with the general population. Diabetic women lose their normal premenopausal protection against cardiovascular disease. Hence the name DEADLY DUO.

Diabetes can cause heart disease through Coronary Artery Disease, Diabetic Cardiomyopathy.

Coronary Artery Disease

Peculiarity in diabetes is that the Atheroma (Cholesterol in the vessel) develops earlier and extensively throughout the arterial tree including smaller arteries. When this atheroma ruptures and blocks the blood vessel supplying the heart, it results in heart attack (Acute myocardial Infarction)

Diabetic Cardiomyopathy

Diabetes may damage the heart muscle directly apart from coronary artery disease. It results in heart failure, risk of arrhythmias (rapid heart rate) may also be increased.

Symptoms Of Heart Disease In Diabetic Patients

Heart attack can occur without pain in diabetic individuals (silent attack) or the pain may be present in unusual sites. It can present as dyspnoea, excessive fatigue.

Diabetes is usually associated with other diseases like increased cholesterol and hypertension which can individually increases the risk of heart disease and with diabetes it forms a deadly combination.

Diabetes also enhances the coagulability (blood clotting) which also increases the cardiovascular risk.

Prevention Of Heart Disease In Diabetic Individual

80% of the diabetic patient die due to heart disease with myocardial infarction accounting for 50% of all deaths.

Regular physical exercise and limited intake of fat and total energy are two measures shown to reduce the cardiovascular events in diabetic patients. Moderate aerobic activities like walking, jogging, swimming and cycling should be encouraged.

Avoid smoking.

Optimizing glycemic control.

Control of high cholesterol and hypertension.

DR. S. Aravindkumar M.D.,DNB ( cardiology )

Consultant – Interventional Cardiologist, Sea Horse Hospital, Trichy