At the Heart of Diabetes

Diabetes mellitus is a chronic condition that can lead to complications over time. These complications can include:

  • Coronary heart diseases  or Cardiovascular disease which can lead to a heart attack
  • Cerebrovascular diseases which can lead to a stroke
  • Retinoplasty (disease of the eye) which can lead to blindness
  • Nephropathy (disease of the kidney) which can lead to kidney failure and the need for dialysis
  • Neuropathy (disease of the nerves) which can lead to, among other things, ulceration of the foot requiring amputation.

Many of these complications produce no symptoms in the early stages, and most can be prevented or minimized with a combination of regular medical care and blood sugar monitoring.

Heart diseases, particularly coronary heart diseases (CHD) are a major cause of morbidity and mortality among patients with diabetes mellitus. At least 68% of people aged 65 or older with diabetes die from some form of heart disease and 16% of people die of stroke. Compared to individuals without diabetes, those with diabetes have a higher prevalence of coronary heart disease (CHD), a greater extent of coronary ischemia, and are more likely to have a Heart Attack (MI) and silent heart attack.

Myocardial infraction – Diabetes is associated with an increased risk of Myocardial Infarction (MI). In the worldwide Inter heart study of patients from 52 countries, diabetes accounted for 10% of the population attributable risk of a first MI.

Silent ischemia and infarction – Some diabetic patients have blunted appreciation of ischemic pain, which may result in non-classical angina symptoms, silent ischemia or even silent infarction.

Diabetes is associated with an increased frequency of unrecognized MI, as well as silent ischemia, at least in men. In comparison, diabetic women were less likely to have a silent infarction.

Why are people with Diabetes at increased risk for CVD?

Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart diseases and stroke. Primarily because people with diabetes, particularly type 2 diabetes, may have the associated conditions that contribute to their risk of developing cardiovascular diseases.

  • High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular diseases doubles.
  • Patients with diabetes have unhealthy cholesterol levels including high LDL (bad cholesterol), low HDL (good cholesterol) and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes.
  • Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure
  • Physical inactivity is another modifiable major risk factor for insulin resistance and cardiovascular disease. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk of heart attack and stroke.

If you have a family history or other risk factors of diabetes or if you have been diagnosed with prediabetes, there are a number of healthy living tips you can follow to prevent or delay the onset of diabetes. If you have already been diagnosed with diabetes, these tips can slow the progression of the disease.

  • Lifestyle changes such as losing weight, eating healthy and increasing physical activity can dramatically reduce the progression of type 2 diabetes and are important for controlling type 1 diabetes. These lifestyle changes can help minimize other risk factors as well, such as high blood pressure and blood cholesterol, which can have a tremendous impact on people with diabetes.
  • In many instances, lifestyle changes must be complemented by a regimen of medications to control blood glucose levels, high blood pressure, and cholesterol as well as to prevent heart attack and stroke.


                                “START EACH DAY WITH GRATEFUL AND HEALTHY HEART”












Dr. Zubair Ali Memon

Specialist Cardiologist

Aster Speciality Clinic, International City


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