The link between diabetes and heart disease
Estimates suggest that 195 million people around the world have diabetes and that this will increase to 330 million or perhaps even 500 million by 2050.
As many as 50 percent of all patients with Type 2 diabetes remain undiagnosed for many years because they have no symptoms. Cardiovascular disease is one of the major complications associated with diabetes.
More than 50 percent of individuals with diabetes eventually develop coronary heart disease, stroke or cardiovascular disease.
Diabetes is an independent risk factor for development of cardiovascular disease with the risk of the disease and its complications increased two to three times compared to non-diabetic individuals. Also, patients with diabetes develop heart disease at a much earlier age.
Duration of diabetes increases the risk of heart disease death independent of coexisting risk factors, and because diabetes is undiagnosed in patients for many years, the complication of cardiovascular disease in these patients is more severe.
Patients with multiple chronic diseases experience bad health outcomes because of fragmented care as they see various clinicians, receive complex medication regimens, and are often noncompliant. Evidence has shown that early diagnosis and aggressive management of risk factors reduces heart disease complications in diabetic patients.
It is important to screen for undiagnosed diabetes in patients with cardiovascular disease, but we have to aggressively treat cardiovascular risk factors in patients with diabetes.
So called metabolic syndrome – a combination of increased waist circumference, glucose intolerance, hypertension, low HDL and elevated triglycerides – is a common link between the development of both diabetes and heart disease. Thus, risk factors for heart disease must be evaluated in patients with diabetes.
Obesity is frequently associated with insulin resistance, development of diabetes, and cardiovascular disease. Weight loss improves control of diabetes, and may decrease heart disease complications. Weight control improves blood pressure – hypertension is directly related to cardiovascular disease.
Physical activity also has a direct link to both diabetes and heart disease.
In both conditions, the increased level of exercise helps to control the disease and reduce complications.
A combination of weight loss and physical activity can reduce increased glucose levels in diabetic patients, frequently leading to a decrease in the dosages of diabetic medications or reduction of the number of medications. Also, it will lead to improvements in the cholesterol profile that are beneficial in patients with and without cardiovascular disease, increasing HDL levels (so called good cholesterol), and decreasing triglyceride levels.
Because both diabetes and heart disease frequently affect the same patients and the risk of complications is increased in these patients, patients who develop one of these conditions should be aggressively screened for the other.
All the risk factors should also be diagnosed and treated aggressively to prevent the development of further complications.
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About the Author
Dr. Maciej Malinski is an Advocate Heart Institute cardiologist on staff at Elgin, Ill.-based Advocate Sherman Hospital. He specializes in cardiology and interventional cardiology, and is board certified in cardiovascular disease, internal medicine and interventional cardiology.