How diabetes affects the heart

Diabetes is a metabolic disorder, where due to inadequate or absent insulin, the body cannot handle sugar. If high blood sugar levels persist in the body for a long time, various organs of the body are damaged, including the heart.

Of all complications of diabetes, its impact on the heart is the one which causes heart diseases in young people. It makes them sick and also affects their vitality and productivity.

Diabetes is part of and also one of the manifestations of the metabolic syndrome. In this one develops central obesity and resistance to the insulin being produced in the body. Hence blood glucose levels go up. These factors along with hypertension increase the risk for coronary artery disease, i.e., where blood supply to the heart is compromised due to the lumen of blood vessels being blocked by fat. High levels of glucose in the blood promote deposition of fat in the inner layers of blood vessels and aggravate this process. Result is, one suffers from pain in the chest while walking or doing some work. If the block is severe or prolonged, affected part of the heart becomes necrotic, a condition called myocardial infarction.

Diabetic patients have a higher prevalence of coronary artery disease as compared to other people and it occurs at a younger age. One usually has silent coronary artery disease due to diabetes. That is, heart attack can occur without any chest pain. It can be a fatal heart attack and the dead myocardium is detected only during post-mortem examination.

Heart failure is yet another complication of uncontrolled diabetes, due to heart muscle being damaged. Gradually it becomes sluggish resulting in heart failure. Outwardly this is manifested as breathlessness on exertion and swelling over the feet. As the disease progresses, there is swelling all over the body, fluid gets collected in the body spaces. One becomes breathless even on rest and individuals spend nights sitting up, bending forwards.

Diabetics are also at greater risk for developing stroke. Once these conditions develop regular medicines are needed throughout life to keep the person symptom free and have a good quality of life. Over time, one develops adverse effects of these drugs, like low blood pressure, dry cough, gastric disturbances, e.t.c. This results in the need to take more medicines to cure the side effects. The net result is a person starts getting more and more dependant on medicines for just moving about.

Interventions like coronary artery bypass surgery or stent implantation can be done in patients who are physically fit for these interventions. In this either a mechanical device is inserted to open blocked vessels of the heart or heart is opened to surgically correct the blocks. These procedures have associated risks.

Prevention of these cardiac problems lies in early detection of diabetes and keeping it well controlled.

A suitable diet is important for keeping the blood glucose levels low. Sugar and saturated fats like cheese, margarine, e.t.c., are best avoided. Ready to eat instant foods like crackers, chips, e.t.c. are bad for the heart and should be avoided. Total calorie intake should be as per the gender and level of physical activity of the individual. The meals should include plenty of fresh vegetables, fruits with fewer carbohydrates like apples and oranges, lean meat like fish and whole grains and cereals. Small frequent meals are necessary. Alcohol should be avoided.

Regular physical activity is important in good control of diabetes. One should exercise daily. But if that is difficult , one should exercise at least 3 times a week. A word of caution. If somebody is not habituated to doing exercise, he/she should start exercising for a very short while initially and then increase the duration gradually. It should be stopped immediately if one experiences chest pain, breathlessness or some discomfort.

Regular check up of blood glucose and regular treatment is very essential. It is important for diabetic patients to go for cardiac evaluation at least once a year. In this way any problem can be detected at its earliest and suitably treated.

A person with diabetes can avoid cardiac problems and maintain good quality of life with suitable diet and regular treatment.