New Delhi [India], October 3 (ANI): Diabetes significantly increases the risk of heart disease and heart attacks, with experts warning that high blood sugar, insulin resistance and inflammation can damage blood vessels and lead to serious cardiac complications.
Dr Ashwin Mehta, Director of the Heart Failure Programme, Cardiology, Sir Ganga Ram Hospital, described diabetes as a "very big driver of heart disease" and explained how prolonged high blood sugar can contribute to cardiovascular damage.
"Diabetes is a very big driver of heart disease. So how diabetes really causes all this is by causing hyperglycemia, which is high sugar, insulin resistance, and systemic inflammation. So there is damage to the lining of the blood vessels, which we call endothelial dysfunction, which is because of glucotoxicity and also because of loss of nitric oxide," Dr Mehta said.
He added that diabetes is often accompanied by increased cholesterol and triglyceride levels, making blood vessels more vulnerable to plaque deposition.
"This is not alone, but you know, the cholesterol levels increase, the triglyceride levels increase; it makes it more vulnerable to deposition. There is also clustering along with diabetes of hypertension and many other problems which can happen and drive up the risk of heart attack," he said.
Dr Mehta said several studies have shown that diabetes can cause cardiovascular complications over a long period and added that people with diabetes can face a significantly higher cardiac risk.
"There have been a number of studies which have been done, which have shown that over a long period of time, diabetes itself can create so many problems. And the studies have shown that there is a very high risk compared to normal people. So much so that we call it that if any person is having diabetes, we should treat that patient as someone who is already having coronary artery disease or who is already having a myocardial infarction, and we call this a myocardial risk equivalent," he said.
Sharing the case of a 45-year-old diabetic patient, Dr Mehta said the man had been unaware of the extent of damage to his heart and presented to the emergency department with what he believed was gastric discomfort.
"This gentleman was 45 years old, and he came to the emergency with an episode of great epigastric discomfort, which he thought was due to gas from eating very rich, fatty food and also eating, you know, some spicy food. And when he came in to the emergency, we did his ECG, and the ECG showed some changes. Now, he had no history of heart attack earlier," he said.
The patient had no history of hypertension but had been diabetic for around 10 years and was taking medicines irregularly. Subsequent angiography showed that all three coronary arteries were completely blocked, with blood flow being maintained through a very small channel in one of the arteries.
"He required bypass surgery. So he was worried that I have no symptoms and how come I've had a sudden onset of so many problems. So this is not sudden and is more common in diabetics," Dr Mehta said.
Dr Naresh Trehan, Chairman and Managing Director of Medanta, also highlighted the difficulty in identifying cardiac complications among people with diabetes, saying nerve damage can reduce the warning signs associated with heart disease.
"People who have diabetes, the nerve endings that give the pain from the heart are damaged, so their alarm system has failed. So they will not get chest pain as an alarm, unless you are getting a heart attack, then maybe. So they keep getting damage to their heart without knowing," Trehan said.
He stressed the importance of regular cardiac evaluation for people with diabetes and said physicians treating diabetic patients should ensure that they undergo timely heart check-ups.
"That's why we always say to the physicians who are treating diabetes to make sure that your patient is getting an echocardiogram or a heart check every year. If it is stable, then maybe every two years. But they should be checked because they don't know that they are destroyed," he said.
Trehan further said he has seen several patients whose heart function had fallen significantly without them being aware of it.
"So many, many patients that walk into my office, they are patients whose heart function has come down to 20%, and they didn't even know that. So they started feeling short of breath. That's when they went and got an echo done, and that's when they found out their heart function is only 20%," he said.
He emphasised that doctors treating diabetes should explain the potential cardiac risks to patients and ensure that they undergo appropriate check-ups.
"It is very important for the physicians also to guide your patients on what the dangers are of what they are suffering from. So we know if somebody has heart disease, we give them the prescription. If there is, if the internist or a diabetologist is treating a diabetes patient, they should make sure that they get their checkup because these are important things for protecting life," Trehan said. (ANI)
Diabetes is a ‘silent driver’ of heart disease, heart attacks: Experts
