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The big health challenge of diabetics

Diabetics are 2 to 4 times more likely to die as a result of coronary disease, compared with non-diabetics. This is quite troubling and the great challenge of any diabetic patient is first and foremost to safeguard his heart. How do you do it?

Over the years it was customary to think that the great concern of patients with type 2 diabetes concentrates mainly on the fear of losing sight or mutilation of limbs as a result of complications, but in fact today it is known that the greatest risk to diabetics is relating to the heart and the brain.

In recent decades there has been a considerable increase in type 2 diabetes in the Western world and it is estimated that by 2025 there will be nearly half a billion diabetics in the world. Diabetes has become quite a pandemic because of the changes in Western diet, including industrialisation and development of processes which include large calorie and sugar overloading alongside a significant reduction in physical activity.

More than one-third of heart patients are diabetics, and 2/3 of diabetics over the age of 65, die of cardiovascular disease or stroke. Therefore, a cardiologist must be an integral part of treating diabetes. It should be noted that in many cases the patients are diagnosed after the disease has been active for several years or being "pre-diabetic", and therefore early intervention in terms of lifestyle and treatment, is essential already from the early stages of diagnosis.

The connection between cardiac disease and diabetes

Coronary heart disease has several risk factors and one of the most significant ones is diabetes. These factors are divided into risk factors that are changeable or non-changeable.

Amongst the factors that can be changed we find smoking and blood pressure. Genetic components, however, are non-changeable factors (at least for now). Previously, it was thought that diabetes is a non-changeable malady but now we know that it can be significantly slowed down and very often reversed. It was usual to classify diabetes in the category of "unchangeable" factors but today we know very well that diabetes should be divided into both categories.

For example, diabetes may develop as a result of an unbalanced diet. In the Western world, we witness a large increase of this phenomena and in developing countries, such as China and India, it has also been observed in recent years. This is mainly due to an economy which is rich in carbohydrates and relative calories. In addition, family history certainly constitutes a risk factor for type 2 diabetes.

Diabetics are at risk of 2-4 times greater than average, of dying as a result of a cardiac disease, compared to non-diabetic people. These are startling proportions and therefore the great challenge of any diabetic patient is first to keep his heart healthy.

The fact that type 2 diabetes is closely linked to cardiac morbidity has been known for years and recently, the British Heart Foundation has announced that because of the constant increase in the incidence of the disease by the year 2035, the number of heart attacks and the strokes in the United Kingdom will increase by 30%.

The way to prevent this dismal prediction from becoming a reality is to take early and distinctive action. It is important to keep in mind that often it is possible to avoid diabetes or to delay the development of the disease and therefore it is necessary to take responsibility and change the way in which we live. Even diabetics, with proper treatment, can reduce their cardiac risk and prevent heart failure in the future.

How does diabetes hurt the heart?

Diabetes is a multi-systemic disease that harms almost all blood vessels in the body, and virtually any organ in the body can be damaged as a result of diabetes. Damage to very small blood vessels such as blood vessels in the eyes may lead to vision disorders and in certain cases to blindness. Damage to small and large blood vessels in the heart – will lead to atherosclerosis or sclerosis other blood vessels that lead blood to the kidneys, the brain, the limbs, and more. In addition, diabetes impairs the heart muscle itself, particularly in its ability to relax. Because of that, the heart effectively fails to transport blood to the lungs which leads to shortness of breath and damage to its functioning.

A recent study which was published in the esteemed scientific journal "New England Journal of Medicine " (NEJM) found that non-smoking type 2 diabetes patients who succeeded in maintaining proper blood pressure values and balanced sugar and cholesterol values, significantly reduced their risk of mortality from a cardiac arrest or stroke compared with non-diabetic counterpart.

The study examined over 271,000 medical cases of type 2 diabetics and compared them to medical cases of a similar population without diabetes. At the same time, the study found that patients who were not balanced in terms of sugar levels, blood pressure, cholesterol and smoking, were at a 10 times higher risk of having a heart attack, a cardiac insufficiency, or a stroke. One of the common complications of type 2 diabetes is a state of cardiac insufficiency, a condition in which the heart does not succeed in the transporting adequate levels of blood to the body – which causes weakness and shortness of breath during effort.

Managing risk factors and reducing risk

The correct treatment of diabetes is also aimed at lowering blood sugar levels (the most significant symptom of diabetes), and also treating the additional risk factors in order to delay atherosclerosis.

This is certainly possible, though it requires discipline, changes in lifestyle and persistence in appropriate drug treatments:

  • Exercising-a sedentary lifestyle leads to obesity which preserves diabetes and insulin resistance in the body. Exercising is a must for any person, but for the diabetic it is critical, and helps reduce weight and improve the indices of sugar, high blood pressure, and cholesterol levels.

  • Cessation of smoking – the combination of diabetes and smoking significantly increases the risk of coronary heart disease. It's hard to quit smoking, but it's worth it, and it's also one of the most outstanding keys to protecting your heart.

  • Proper nutrition – significant dietary changes are required when dealing with type-2 diabetes. Among other things, in order to reduce weight and improve additional risk factors. A Mediterranean or a very low calorie diet (VLCD)is usually a recommended diet for diabetes, but it is important to consult a nutritionist who specializes in type 2 diabetes in order to build a personal menu, one that will help control the disease, and bring about the reduction of cholesterol and blood pressure.

  • Innovative drug therapy – since the discovery of the insulin that won the Nobel Prize a hundred years ago, the diabetic treatment has progressed over the years and in recently has passed a real revolution. There are currently innovative drug therapies that work not only to lower the blood sugar values, but also to reduce weight and decrease blood pressure. In addition, several studies show that some of the treatments are also helping reduce coronary events, and reducing recurring hospitalisations as a result of heart failure.

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