Why Heart Disease Is Common in People With Diabetes
People with diabetes tend to have more “bad” (LDL) cholesterol and less “good” (HDL) cholesterol. HDL cholesterol helps move bad cholesterol from the bloodstream to the liver. Over time, excess LDL cholesterol in the bloodstream is deposited inside blood vessels, where it sticks to the walls of the vessels and interferes with blood flow.If the vessels leading to the heart become clogged, this can lead to a heart attack. If vessels leading to the legs become clogged, peripheral arterial disease (PAD) can result.
In addition to cholesterol levels, diabetes itself can bring about significant cardiac health risk, due in part to changes in the blood vessels produced by hyperglycemia, changes in blood coagulation properties, and changes in the plaques that form in the blood vessels of diabetics.
Minimizing Your Risks for Heart Disease
People with diabetes are two to four times more likely to have a stroke or heart attack than those without the disease. They are also at a higher risk for PAD. However, this doesn’t mean heart disease is inevitable. A great deal can be done to help minimize the risks.Research has shown that making certain healthy lifestyle changes can reduce the risk of heart disease. Eating a heart-healthy diet, achieving an optimal weight and sticking to a daily exercise routine all help.
In addition, several studies have found that keeping blood sugar levels within a target range is vital. According to researchers at the Johns Hopkins Bloomberg School of Public Health, for each percentage point increase in A1c levels, the risk of heart disease increases by 14%. Anyone with diabetes should make sure to check blood sugar levels regularly. A health care provider can help set an ideal target range for blood sugar levels.
Symptoms of Heart Disease
Chest pain is a common heart attack symptom. Since diabetes can impact the nerves, some people with diabetes have heart attacks without experiencing any pain whatsoever. These so-called silent heart attacks are not usually diagnosed until a routine medical exam.Anyone who has experienced a silent heart attack is at greater risk for another, more serious heart attack and should be closely monitored by a cardiologist.
In addition to chest pain, heart attack symptoms can include:
- Discomfort or pain in the back, arms, neck or stomach
- Shortness of breath
- Sweating or lightheadedness
- Nausea or indigestion
- Extreme weakness or anxiety
Peripheral arterial disease may also reveal no symptoms, particularly in someone who has diabetic neuropathy, a condition that affects the nerves, making it difficult to feel sensation. A doctor may order an ankle-brachial index to diagnose PAD, or check the pulses in the feet and legs to see if circulation is impaired.
Some symptoms of PAD include:
- Painful cramps in the thigh, calves or hips during such exercise as walking or stair climbing
- Persistent leg pain that continues even after exercise is stopped
- Wounds on feet that are slow to heal or don’t heal
- Gangrene
- A much lower temperature in the affected foot or leg compared to rest of body
Sources:
“Heart Attack Symptoms.” The Cleveland Clinic Heart and Vascular Institute. (Sep. 2006). The Cleveland Clinic. 7 Sep 2007.
"Diabetes and cardiovascular disease: Lifestyle changes and medication can improve your health." Mayo Clinic. 05 May 2005. CNN. 8 Sep 2007
Van der Horst, Iwan C.C., M.W.N Nijsten, M. Vogelzang, and F. Zijlstra. “Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction.” (2007) Cardiovascular Diabetology. 6:2. 7 Sep 2007.
Selvin, Elizabeth, S. Marinopoulos, G. Berkenblit, T. Rami, F. L. Brancati, N. R. Powe, and S. H. Golden. “Meta-Analysis: Glycosylated Hemoglobin and Cardiovascular Disease in Diabetes Mellitus.” Annals of Internal Medicine. (2004). 141: 421 – 31.
“Know the Warning Signs of a Heart Attack.” Diabetes.org. 5 Sep 2007. American Diabetes Association. <>.
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