By Haris Turalic, MD, F.A.C.C. –
If you saw a lion, you’d run for your life. But what if you didn’t see it? For those of you with type 1 or type 2 diabetes, heart disease is that unseen lion. You’re two to four times more likely to develop a heart condition than people without diabetes. Even more shocking, those individuals are more likely to die from heart disease or other cardiovascular problems than from the complications of diabetes itself. Yet surveys show that 68 percent of Americans with diabetes are unaware of their increased cardiovascular risk.
Diabetes by itself is now regarded as the strongest risk factor for heart disease. Let’s take a closer look at the links between diabetes and cardiovascular disease (CVD):
. CVD is a major complication of diabetes and the leading cause of early death among people with diabetes—about 65 percent of people with diabetes die from heart disease and stroke.
. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes.
. High blood glucose in adults with diabetes increases the risk for heart attack, stroke, angina, and coronary artery disease.
. People with type 2 diabetes also have high rates of high blood pressure, lipid problems, and obesity, which contribute to their high rates of CVD.
. The American Heart Association considers diabetes to be one of the six major controllable risk factors for CVD.
. Smoking doubles the risk of CVD in people with diabetes.
The increased risk for heart disease often begins years before diabetes is diagnosed. With more than 60 million adults in the U.S currently at increased risk for developing diabetes, the best way to prevent or delay the development of cardiovascular disease is to prevent diabetes itself.
Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That’s because people with diabetes, particularly type 2 diabetes, often have the following conditions that contribute to their risk for developing cardiovascular disease:
High blood pressure (hypertension) has long been recognized as a major risk factor for CVD. 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 CVD doubles.
Abnormal cholesterol and high triglycerides Patients with diabetes often 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.
Obesity is a major risk factor for CVD 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.
Lack of physical activity is another modifiable major risk factor for insulin resistance and CVD. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke. It’s likely that any type of physical activity—whether sports, household work, gardening or work-related physical activity—is similarly beneficial.
Poorly controlled blood sugars (too high) or out of normal range Diabetes can cause blood sugar to rise to dangerous levels. Medications may be needed to manage blood sugar.
Smoking puts individuals, whether or not they have diabetes, at higher risk for heart disease and stroke.
Taking actions to prevent diabetes is a proven way to drastically decrease your risk of developing CVD. Individuals with insulin resistance or diabetes in combination with one or more of these risk factors are more likely to fall victim to heart disease or stroke. However, by controlling these risk factors, diabetes patients may avoid or delay the development of CVD. Your health care provider will do periodic testing to assess whether you have developed any of these risk factors associated with CVD.
In addition to controlling the above risks, it is vital for patients with diabetes to have regular cardiovascular screenings. Early signs of cardiovascular problems can be detected with screening tests such as ECG, cartoid artery screening, and functional stress testing. Unfortunately too many people, even those with diabetes, do not receive regular preventative cardiovascular screenings. Detecting cardiovascular abnormalities before a problem (heart attack or stoke) occurs can save your life.
Sources: American Heart Association (AHA), U.S. Department of Health and Human Services
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