Cardiac Risk Factors and Diabetes Mellitus

Introduction

Diabetes, one of the most common and chronic diseases in the world, affects individuals of all age groups and is a major risk factor for cardiovascular diseases. Diabetes decreases the ability of the heart to function normally, which in the long run affects several organ systems in the body. Hence, it is crucial to diagnose diabetes and identify the risk for cardiac conditions early in diabetic patients so that the mortality rates are decreased.

What Is Diabetes Mellitus?

Diabetes mellitus is a medical condition in which insulin production is inefficient. Normally, following the ingestion of food, the body breaks down sugar from the food to provide energy for daily activities. To accomplish this, the pancreas produces a hormone known as insulin. Insulin is an important hormone that facilitates breaking down sugars and provides energy to the body's cells for normal functioning. Hence, when insulin production is inefficient, this results in elevated levels of sugars in the body due to inadequate breakdown. Without insulin, glucose does not enter the body's cells and is excreted via urine. Increased blood glucose concentration also results in water loss from the body's cells. This kind of deprivation can lead to several problems in nearly every system of the body.

What Are the Causes of Diabetes?

The numerous causes of diabetes are -

• Hereditary and genetic predisposition.

• Damage to the pancreas.

• Removal of pancreas.

• Unfavorable environmental factors.

• Sedentary lifestyle.

• Unhealthy eating habits.

• Autoimmune diseases in which the body destroys the beta cells that are responsible for the production of insulin.

• Obesity.

• Alcohol abuse.

• Smoking.

What Are the Signs and Symptoms Associated With Diabetes Mellitus?

The signs and symptoms associated with diabetes mellitus are as follows -

• Increased thirst.

• Excessive urination.

• Sudden loss of weight.

• Unusual tiredness.

• Blurry vision.

• Mood swings.

• Increased incidence of infections, such as gum, vaginal, and skin infections.

• Sores, cuts, and bruises take more time than usual or, sometimes, never heal.

• Tingling and numbness in the hands and feet.

How Does Diabetes Mellitus Affect the Heart?

Diabetes mellitus affects the heart in several ways, such as -

• Diabetes mellitus makes people susceptible to coronary artery disease. This common phenomenon occurs due to the stiffening of the blood vessels that carry oxygen-rich blood. Such blood vessels also tend to have more fatty deposits in them.

• Diabetes also affects cardiac muscle function. It is often seen that diabetic patients have poor cardiac muscle function, which affects their normal functions, such as contraction and relaxation of the heart, that are associated with pumping blood.

• Heart muscles and associated structures also become weak because of the decreased energy availability for the body cells to function normally.

• Diabetes also sets off several inflammatory reactions in the blood vessels, which can lead to the thickening of the blood and the formation of blood clots. This impedes the blood flow to the heart muscle, and when the heart muscle is deprived of blood, it is also deprived of oxygen and nutrients. This can eventually result in a heart attack.

• Following a heart attack, poor recovery is seen in diabetic patients since the heart muscle are deprived of the essential energy, blood, and oxygen that are prerequisites for healing and recovery. Hence, in such individuals, the risks associated with heart attack and heart failure are much higher than their non-diabetic counterparts.

• Diabetes is also associated with nerve damage. Because of this, patients often do not feel the early or crucial signs of heart disease, such as chest pain. In such individuals, heart disease is hence detected at a later stage. The longer the delay in detecting heart disease, the fewer treatment options, and the survival rates decrease exponentially.

• Diabetes is also directly associated with increased cholesterol levels and triglycerides. This increases the risk of atherosclerosis, a condition in which the blood vessels in the body are obliterated, partially or completely, because of fatty deposits. This results in decreased or diminished blood flow to the heart and its associated structures.

How Is Diabetes Diagnosed?

The following tests are employed for the diagnosis of diabetes mellitus -

• Random Blood Sugar Test: This test can be performed at any time of the day, and a value higher than 200 mg/dL (milligrams per deciliter) indicates diabetes mellitus.

• Fasting Blood Sugar Test: This test is usually performed in the morning after fasting for several hours at night. A value of 126 mg/dL or higher in two consecutive tests indicates diabetes.

• Oral Glucose Tolerance Test: This type of test involves checking the blood glucose every two hours after keeping a fast for the entire night.

• Glycated Hemoglobin (A1c) Test: This test does not require the patient to fast overnight. It is the most accurate test and measures blood sugar for the last two to three months by measuring the percentage of blood sugar attached to the hemoglobin in the blood.

What Are the Cardiac Risk Factors in Diabetic Patients?

The following are the cardiac risk factors that are found in diabetic patients -

• Obesity.

• High blood pressure, otherwise known as hypertension.

• Increased levels of lipids in the body, also known as dyslipidemia.

• Atherosclerosis.

What Measures Can Help Reduce Cardiac Risk Factors in Patients With Diabetes Mellitus?

The following measures can help reduce the cardiac risk factors in diabetic patients -

• Regulate Weight - Obesity loads the heart with excess strain, increasing the risk of cardiac diseases. Obesity is also associated with atherosclerosis, which essentially leads to the formation of atheromas. Atheromas are deposits made of fat and cholesterol, blocking the blood vessels in the body. This damages the heart muscles due to decreased blood and oxygen supply. Physical activity helps in regulating body weight. Diabetic patients should aim for at least 30 minutes of moderate to vigorous physical exercise a day. A balanced, nutritious, and junk-free meal is equally important in regulating excess body weight.

• Regulate Blood Pressure - Hypertension is associated with irreversible damage to the blood vessels. This reduces elasticity, leading to inefficient blood flow to the heart. Hypertension can result in heart attacks, chest pain, and heart failure. Hence, it is vital to have a healthy lifestyle, including physical activity, and reduce stress and anxiety. With all these measures, the heart muscle recuperates well, therefore, becomes stronger. This leads to the even distribution of oxygen-rich blood to the entire body and prevents cardiac diseases.

• Quit Smoking - Smoking, in general, deteriorates heart health, but when coupled with diabetes, it can exponentially worsen heart health. Smoking also impairs healing, and when diabetic patients smoke, healing and regeneration of cells take a longer time. In specific individuals, healing may stop, leading to unwarranted infections. Hence, it is necessary to quit smoking, and patients should reach out for help to do so. Doctors can suggest several ways to cease smoking. Studies reveal that people who do not smoke have better heart health when compared with those who smoke. Furthermore, exercising regularly makes people less susceptible to start smoking, a significant and crucial risk factor for cardiac disease in diabetic patients.

• Include Weight Training to Strengthen Muscles - Exercise such as aerobic exercises, running, swimming, walking, jogging, and other activities, along with strength training, help improve heart health in diabetic patients. It also helps in improving insulin sensitivity in such individuals. The various exercises with weights and resistance training enhance the cardiac muscles' capacity to absorb oxygen from the circulating blood. Strength and resistance training also helps create lean muscle mass by cutting fat.

Conclusion

Diabetes mellitus is an endocrine disorder that is characterized by inefficient degradation of blood sugar. In other words, it is a chronic disease in which blood sugar is not processed correctly. Insulin is a hormone, secreted from the pancreas and it is designated to control the levels of blood sugar in the body. Diabetes has a close association with heart health and hence, it is important to identify the cardiac risk factors and work on eliminating them. A combination of physical activity, and a nutritious diet, are extremely important in regulating such cardiac factors. Although it is a life-changing disease, if appropriate measures are taken, patients can live long and happy life.