Diabetes Mellitus and Heart Disease

Diabetes mellitus is hard enough to deal with in everyday life. Unfortunately, this disease leads to many other serious conditions, one of which is heart disease, which leads to a heart attack. This discusses the link between diabetes mellitus and heart disease.

What is the connection between diabetes mellitus, heart disease, and stroke?

If you have diabetes mellitus, you are at least twice as likely as someone who does not have diabetes mellitus to have heart disease or a stroke. People with diabetes mellitus also tend to develop heart attack or have strokes at an earlier age than other people. If you are middle-aged and have type 2 diabetes mellitus, some studies suggest that your chance of having a heart attack is as high as someone without diabetes mellitus who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes mellitus have an increased risk of heart disease because diabetes mellitus cancels out the protective effects of being a woman in her child-bearing years.People with diabetes mellitus who have already had one heart attack run an even greater risk of having a second one. In addition, 
heart attacks in people with diabetes mellitus are more serious and more likely to result in death. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).

Facts about diabetes mellitus 

Cardiovascular disease is the major cause of death in diabetes mellitus, accounting for some 50% of all diabetes mellitus fatalities, and much disability.
On average, people with type 2 diabetes mellitus will die 5-10 years before people without diabetes mellitus and most of this excess mortality is due to cardiovascular disease.
People with type 2 diabetes mellitus are over twice as likely to have a heart attack or stroke as people who do not have diabetes mellitusIndeed, people with type 2 diabetes mellitus are as likely to suffer a heart attack as people without diabetes mellitus who have already had a heart attack.
Strokes occur twice as often in people with diabetes mellitus and hypertension as in those with hypertension alone.
People with diabetes mellitus are 15-40 times more likely to have a lower limb amputation compared to the general population.
People with diabetes mellitus have two to four times the risk of developing atherosclerosis compared to people without diabetes mellitus.
The treatment of cardiovascular disease accounts for a large part of the huge healthcare costs attributable to type 2 diabetes mellitusthat have been estimated to account for 10-12% of European health care expenditure.
Part of the cardiovascular risk associated with IGT and diabetes mellitus is undoubtedly due to their association with other cardiovascular risk factors such as hypertension, high LDL-cholesterol and low HDL-cholesterol and smoking.
Lifestyle changes that improve blood glucose control e.g. weight loss, dietary changes and increased physical activity are also likely to improve these other cardiovascular risk factors.

What are the risk factors for heart disease and stroke in people with diabetes mellitus?

Diabetes mellitus itself is a risk factor for heart disease and stroke. Also, many people with diabetes mellitus have other conditions that increase their chance of developing heart disease and stroke. These conditions are called risk factors. One risk factor for heart disease and stroke is having a family history of heart disease. If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.
You can't change whether heart disease runs in your family, but you can take steps to control the other risk factors for heart 

disease listed here:

Having central obesity.

 Central obesity means carrying extra weight around the waist, as opposed to the hips. A waist measurement of more than 40 inches for men and more than 35 inches for women means you have central obesity. Your risk of heart disease is higher because abdominal fat can increase the production of LDL (bad) cholesterol, the type of blood fat that can be deposited on the inside of blood vessel walls.

Having abnormal blood fat (cholesterol) levels. 

  • LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteries-the blood vessels that carry blood from the heart to the rest of the body. Arteries can then become blocked. Therefore, high levels of LDL cholesterol raise your risk of getting heart disease.
  • Triglycerides are another type of blood fat that can raise your risk of heart disease when the levels are high.
  • HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal. Low levels of HDL cholesterol increase your risk for heart disease.

Having high blood pressure

If you have high blood pressure, also called hypertension, your heart must work harder to pump blood. High blood pressure can strain the heart, damage blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.


 Smoking doubles your risk of getting heart disease. Stopping smoking is especially important for people with diabetes mellitus because both smoking and diabetes mellitus narrow blood vessels. Smoking also increases the risk of other long-term complications, such as eye problems. In addition, smoking can damage the blood vessels in your legs and increase the risk of amputation.

How to minimise the Risk of Heart Disease

People who have diabetes mellitus that goes undetected and untreated face an increased risk for heart disease because atherosclerosis may occur at earlier-than-expected ages and more sever in diabetics.  People who have diabetes mellitus-related atherosclerosis in their coronary arteries sometimes suffer what is called “silent ischemia” or silent heart attack.  Silent, in this case, means without typical pain because neuropathy, or nerve damage, is a result of uncontrolled diabetes mellitusThese people will not feel many sensations of touch, vibration, heat, cold or pain, and this may also include the expected pain of a heart attack.  The resulting vague -- instead of acute -- symptoms may be ignored, or passed off as indigestion or stomach upset.  When there is damage to the autonomic nervous system, signals that should be sent to the brain to regulate heart rate and blood pressure are blocked. 

Early diagnosis and learning how to monitor and control the disease are key to avoiding complications down the road.  Some experts suggest that the course of this disease can be changed when patients:  

  • Adopt a good attitude
  • Are committed to doing what is necessary to learn about their condition and its treatment, and
  • Make a conscious decision to control the disease instead of allowing the disease to control them. 

Diabetics respond to almost the same health regimen that helps heart patients recover.  A closely monitored and controlled 
diet that involves reducing the intake of sugar and fats, and increasing the amounts of complex carbohydrates and fiber; weight control and smoking cessation; and a regularly performed aerobic exercise routine can be critical to both groups. 

A specially tailored exercise regimen can lower triglycerides and blood glucose, heighten sensitivity to insulin and lower blood pressure.  When a person begins aerobic exercise, muscle glycogen is the primary fuel.  After five to 10 minutes, glucose uptake from blood is seven to 20 times the resting rate, depending upon how strenuous the exercise is and diabetics can benefit from this uptake. 

If you are over 40 and notice any vague symptoms -- fatigue, constant thirst, excessive urination, transient blurred vision, or even that minor skin injuries take a long time to heal -- make an appointment with you physician.  If there are other diabetics in your immediate family or if you are more than 20 percent over your ideal body weight, schedule a physical examination as soon as possible. 

There is no cure for diabetes mellitus, but with careful monitoring and commitment, diabetics can avoid complications and enjoy a long, productive life.  Making an equally important commitment to reduce the risks of cardiovascular disease can help make this possible.

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