Preventing Complications

Uncontrolled diabetes brings a host of complications along with it. These can often be prevented or managed by following some key principles.

 

Good Sugar Control and the Heart

Uncontrolled diabetes can damage many parts of the body and can also lead to heart attacks and strokes, one of the leading causes of death for people with diabetes. In comparison with people who don't have diabetes, people who have diabetes:
  • Are at two to four times higher risk for heart disease.1
  • May develop heart disease at a younger age2
  • May have silent heart attacks, which can lead to delay in getting help for the patient (silent means people with diabetes usually don’t feel chest pain)
  • Women of all ages with diabetes have an increased risk of heart disease3.
 
Why does it happen?
 
Diabetes can lead to cardiovascular damage in many ways. When a person has uncontrolled diabetes, his/her blood sugar levels are usually higher which damages blood vessels and results in hardening of the arteries. This damage makes it easier for fatty deposits to form in arteries and results in narrowing or blockages of the important blood vessels. If this blockage is in the vessels of heart, it can cause a heart attack. If this blockage is in the vessels leading to brain, it can cause a stroke. Along with, it may also happen that chest pain may not be felt by people with diabetes because of autonomic neuropathy (nerve damage due to uncontrolled diabetes).
 
Although these facts seem gloomy, there are millions of people who live normal and active lives with diabetes. Here are the 4 tips that can help you to keep your heart healthy even when having diabetes.
  1. The goal of any diabetes treatment is to keep blood glucose levels near normal. Check your blood glucose as advised. Along with regular self-monitoring, you can see if your blood glucose is under control by having an HbA1C test. This test tells you your average blood glucose control for the past 3 months. The target HbA1C for most people with diabetes is below 7. Insulin is essential if HbA1c is more than 10 and needs to be considered if HbA1C is going above 7.5% 4. Early use of insulin can add flexibility and good control in the life of a person with diabetes. Thin needles and newer pen devices have made insulin therapy comfortable now.
  2. Type 2 diabetes often coexists with other high-risk conditions such as hypertension, high cholesterol and obesity which add to cardiovascular risk factors. Along with HbA1C test, regular blood pressure check-up, lipid profile, routine heart screening and electrocardiogram tests during rest, and treadmill are essential for people with diabetes. Ask your doctor what medication you should take to minimize these risk factors. GLP-1 based therapy offer better cardiovascular benefits for people with type 2 diabetes.
  3. Make sure you can recognise the early signs of coronary heart disease. Tightness or discomfort in the chest, neck, arm or stomach which comes on when you exert yourself but goes away with rest may be the first sign of angina. People with diabetes sometimes do not feel classic symptoms, and symptoms that are felt may be ignored, or passed off as indigestion or stomach upset, vague dizziness or weakness.
  4. Don't smoke. Quitting smoking is the single most important thing a person can do to live longer. From the moment you stop smoking, the risk of heart attack starts to reduce.
Lastly, do not make diabetes a stress. It is essential to follow a healthy lifestyle along with medication and monitoring. Visit the lifestyle section for important tips.
 
References:
  1. Wingard DL, Barrett-Connor E. Heart disease and diabetes. In: Harris MI, Cowie CC, Stern MP, Boyko EJ, Rieber GE, Bennett PH, eds. Diabetes in America. 2nd ed. Bethesda, Md.: National Institutes of Health, 1995:429-48. (NIH publication no. 95-1468.)
  2. GL Booth, MK Kapral, K Fung, JV Tu - The Lancet, 2006 - Elsevier Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study
  3. Manson JE, Colditz GA, Stampfer MJ, et al. A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 1991;151:1141-1147
  4. Silver B, Ramaiya K, Andrew SB. et al. EADSG guidelines: insulin therapy in diabetes. Diabetes Ther 2018; 9 (02) 449-492
 




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1. Estimated from IDF 7th Atlas 2015
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