Diabetes also has an impact on the cardiovascular system
Diabetes also has an impact on the cardiovascular system, making diabetics a group that is particularly susceptible to heart disease. Blood vessels are harmed by too much sugar in the blood, which also hastens atherosclerosis and raises the risk of heart attack and stroke. However, not all diabetics are destined to develop heart disease; a lot depends on the patient and his attitude, the doctor explains. Piotr Kdzierski from the Otwock-based European Health Center.
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Doctor, how common are cardiovascular problems in diabetics?
People with type 2 diabetes, which is very prevalent, are particularly vulnerable to cardiovascular disease. According to epidemiological studies, 60–70% of diabetic patients experience these complications. The duration of diabetes causes an increase in this percentage.
This is due to a number of metabolic disorders brought on by high blood glucose levels, tissues that are resistant to insulin, a characteristic of type 2 diabetes, and a gradual drop in blood insulin levels. The pancreas initially secretes excessive amounts of insulin in the early stages of diabetes, which does not function properly on the tissues. As a result, pancreatic reserves are reduced until they are completely depleted. This decrease in insulin concentration in the blood is the result.
What are the most common heart diseases diagnosed in people with diabetes?
Premature development of atherosclerotic lesions is the most frequent cardiovascular complication in diabetics. This is true, for instance, of the coronary arteries, where the condition known as ischemic heart disease can result in a heart attack if left untreated.
These alterations may also have an impact on the visceral arteries, which supply the organs in the abdominal cavity, as well as the cerebral circulation, which can result in a stroke and a decline in cognitive abilities. In this instance, intestinal ischemia happens after meals and is characterized by diarrhea and abdominal pain, which ultimately causes cachexia. For fear of pain, the patient avoids eating, and intestinal ischemia causes malabsorption and persistent diarrhea.
The peripheral arteries also develop atherosclerotic lesions, most frequently in the lower limbs, which causes intermittent claudication, or severe pain in the calf area when walking. In more advanced lesions, ischemia may be the cause of ulcerations and hard-healing wounds, or so-called diabetic foot syndrome, which frequently results in amputation.
When discussing type 2 diabetes and heart disease, it's important to keep in mind that poorly controlled diabetes can also harm the kidneys. The progression of atherosclerotic lesions is accelerated and intensified by kidney dysfunction, which also results in myocardial fibrosis and heart failure.
Could these diseases be related to the medications you are taking?
Severe atherosclerosis leads to organ ischemia and organ failure. Chronic hyperglycemia, i.e. elevated glucose concentration, also damages cells by disturbing their metabolism.
Medication has no effect on diabetic heart disease. These medications should be taken because they not only lower glucose levels but also guard against complications. In addition, new medications used to treat type 2 diabetes, such as flozins (SGLT-2 receptor inhibitors) and GLP-1 analogues, are also effective in treating heart and kidney failure in people who do not have the disease.
What symptoms should alert a diabetic patient?
Numerous organ systems, including the nervous system, are adversely affected by diabetes. Due to this, a patient with ischemic heart disease, such as a heart attack, may not experience the typical symptoms, such as a severe, agonizing chest pain.
A routine ECG or echocardiogram that is performed on a person who has had a heart attack due to shortness of breath can identify the fact that he has had a heart attack. When a diabetic person experiences a heart attack, the symptoms are frequently mild and vague, such as a little discomfort in the chest, epigastric pain, nausea, and vomiting. Arrhythmias that the patient experiences as palpitations can also be caused by ischemic heart disease.
Does a diabetic need to be under the constant care of a cardiologist? And if not - when should he go to him for the first time?
A diabetic should continue to receive routine care from a family doctor, who first informs the patient about the critical value of regular exercise and a healthy diet before beginning pharmacological treatment.
The patient is sent to a cardiologist if the family doctor suspects cardiac complications. The patient should continue to receive ongoing care from a cardiologist if cardiac complications are discovered during an ECG, echocardiogram, or other specialized tests.
A diabetic patient must follow a diet due to the level of glucose. What can not be eaten because of the heart?
When compared to the diet of every patient with type 2 diabetes, the diet of a patient with cardiac complications is not significantly different. Simple carbohydrates should be avoided in favor of complex carbohydrates, which include items like sugar, white bread, pasta, sweets, and alcohol (dark bread and pasta).
It is advisable to limit animal fats in favor of vegetable oils rich in polyunsaturated fatty acids, and to limit the consumption of red meat, i.e. pork and beef, in favor of fish.
What physical activity is most beneficial for such people?
The most beneficial is aerobic exercise, i.e. one during which we consume a lot of oxygen, to put it simply, we breathe more often. - e.g. running, fast and long walks, cycling, swimming.
Isometric exercise, like lifting weights in the gym, is less advantageous, but moderate loads increase muscle mass and, as a result, increase the amount of glucose that muscles use. It also reduces insulin resistance, which enhances diabetes management. It is crucial that we spend at least 150 minutes per week engaged in physical activity.
Is it possible to prevent cardiovascular complications with newly diagnosed type 2 diabetes, or are they inherent in this disease?
The development of cardiovascular complications of diabetes can be prevented with good glucose control, which is primarily attained through regular exercise, a healthy diet, and quitting smoking. Modern antidiabetic medications that lower cardiovascular risk are then used as a last resort. Much of this disease's treatment depends on the patient and how he views the process. (Hubicz)
Hubicz, Katarzyna. “‘Nie Każdy Diabetyk Jest Skazany Na Chore Serce’. Lekarz Radzi, Jak Uniknąć Groźnych Powikłań Cukrzycy.” “Nie Każdy Diabetyk Jest Skazany Na Chore Serce”. Lekarz Radzi, Jak Uniknąć Groźnych Powikłań Cukrzycy - PoradnikZdrowie.pl, 18 Nov. 2022, www.poradnikzdrowie.pl/zdrowie/cukrzyca/chorujesz-na-cukrzyce-lekarz-wyjasnia-jak-wtedy-dbac-o-serce-aa-XKbC-MZEn-TiSN.html.