Diabetes Can Increase Risk of Heart Disease, 5 steps to Prevent The Same : Suggestion By Diabetologists In Vashi, Navi Mumbai | Dr. Vinod Methil

 

Diabetics in general have a higher risk of heart ailments. Studies have suggested that 60% of diabetic patients above the age of 65 years are at a risk of heart attack. Over the past few years we are increasingly seeing this in younger population. The central pathological mechanism in Heart disease is atherosclerosis. Atherosclerosis is known to lead to coronary heart disease and cardiovascular events. With close to 70% mortality, cardiovascular disease (CVD) is the leading cause of death in people with type 2 diabetes. The risk factors of CVD are age, obesity, tobacco use, dyslipidaemia, and hypertension. Diabetes itself is an independent risk factor of CVD.¹

How does diabetes affect the heart?

People with diabetes (particularly type 2 Diabetes) frequently have many traditional risk factors for CVD, including central obesity, dyslipidaemia (high serum triglyceride, low-density lipoprotein, and free fatty acid levels and low high-density lipoprotein levels), and hypertension, the combination of which constitutes the metabolic syndrome. These factors, together with the independent risk factor of diabetes, can independently as well as cumulatively increase risk of CVD significantly over time. Hyperglycaemia and insulin resistance, when combined with dyslipidaemia, hypertension and chronic inflammation, can damage blood vessels, resulting in macrovasculopathy and CVD in people with type 2 Diabetes

It has been shown that the risk of myocardial infarction (Heart attack) in people with diabetes is equivalent to the risk in nondiabetic patients who have already had a Heart attack.

Further evidence of the association between diabetes and CVD is provided by the observation that most patients with coronary heart disease have insulin resistance or frank diabetes.

Diabetes generally occurs due to insulin resistance in the body. This resistance can also lead to high blood pressure. It occurs because as the blood sugar level goes up, the body tries to compensate by increasing the insulin levels leading to hyperinsulinemia. Which leads to Atherosclerosis (blockage of the blood vessels. The diabetogenic lipid condition significantly increases the rate of cholesterol deposition in the blood vessels as compared to a non-diabetic. Which can occur anywhere in the body. However, preliminary symptoms can be seen in places where the blood vessels are relatively thin like the brain, heart, renal blood vessels or where the sources of blood supply is limited like the foot. However, due the increasing bad lifestyle, we are witnessing an increase in diabetes induced heart complications. This is increasingly being seen in younger diabetic patients.

Who is at a risk of severe diabetic heart complications:

Generally speaking, almost every diabetic patient who does not have his critical parameters in check is at a risk of severe diabetic heart condition. Nonetheless, patients who have a family history of heart condition have an increased risk of heart condition.

Early symptoms of heart ailments due to Diabetes:

Unlike a normal person who would have severe chest pain when having a heart attack; a diabetic patient may not experience similar pain. Hence, diabetes is known to be a silent killer However, there are some symptoms which could occur. Some early signs could be

1. Breathless on minimal exertion & dizziness
2. Heaviness in the chest
3. Palpitations

How we at Sweet Clinic saved a patient form a heart attack

We had a 45 year old female patient who was diabetic with a high blood pressure but no cardiac history. She was on typical medication for controlling her diabetes and high blood pressure. She even did her regular medical check-ups. Nonetheless, in one of her regular diabetic check-ups she mentioned of breathlessness. Our Diabetologist; Dr. Vinod Methil, who is quite pedantic when it comes to such symptoms in his patients, immediately asked her to do a heart rate variability test (We being the only clinic in Navi Mumbai to offer such a test). The test result suggest that she might have Cardiac Autonomic Neuropathy (CAN)a frequent but underdiagnosed complication of Diabetes. Following which she was referred to a heart specialist for an angiography. During angiography a heart block was identified and needed a stent to remove the block. This prompt action saved her form a potential heart attack and helped save her life too. All thanks to Dr. Vinod Methil and his team at Sweet clinics.

Steps to prevent diabetic heart complications:

Most diabetic patients only concentrate on blood sugar fasting & PP. They often ignore other critical parameters like cholesterol, lipids, creatinine etc. which can help prevent from diabetes induced complications. Hence, at Sweet clinics some of the preventing measures that we do with our patients include:

1. First and foremost, one needs to bring the Blood sugar, Blood pressure & cholesterol in tight control.

It’s important to know that normal blood pressure in Diabetic patients is slightly lower than that of a regular person. For Diabetic and hypertensive individuals at higher cardiovascular risk (existing atherosclerotic cardiovascular disease or 10-year atherosclerotic cardiovascular disease risk >15%), a blood pressure target of <130/ 80 mmHg may be appropriate, if it can be safely attained.

1. Similarly, the lipids & cholesterol need for Diabetics with no high blood pressure and LDL cholesterol of 100 milligrams per decilitre of blood is considered ok. However, if a Diabetic has already had a cardiac problem identified the LDL cholesterol should be less than 70 milligrams per decilitre of blood.
2. In individuals with Diabetes having multiple atherosclerotic cardiovascular disease risk factors, it is reasonable to start with high-intensity statin therapy.
3. For subjects who are unable to tolerate the intended intensity, the maximally tolerated statin dose should be considered.
4. The above parameters need to be brought in control by using medications and bringing about lifestyle changes like controlling ones weight, employing healthy lifestyle like regular exercise and stop smoking while limiting or eliminating alcohol altogether.
5. Source: https://www.sweetclinics.com/diabetes-can-increase-risk-of-heart-disease-5-steps-to-prevent-the-same/

Controlling Obesity is easy if you have the Right Help..!

Obesity has become the single biggest reason for type 2 diabetes in India and the world. Most of this is due to the increasing sedentary lifestyle and abnormal eating habits. Even though most people blame new-age lifestyle as the cause for obesity, it’s primarily due to the mindless eating and lack of general awareness of oneself that is accelerating the process of becoming obese. Being Obese is an early sign that the body is out of balance and if left uncheck it can lead greater problems like Type-2 diabetes. Diabetes in turn is an early sign of greater things to come like Heart attack and various other ailments.

So how does one know if he or she is actually OBESE?

To know if someone is Obese or Normal, we generally calculate BMI. Anyone with a BMI greater than 30 is considered Obese. The chart below shows the classification

Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

Most people find it difficult to keep a track of ones BMI. Well for all such people there is am more basic way to calculate if one is overweight or Obese. Its starts by knowing the height and the below formula gives the normal weight of a person.

Normal weight of a Female (Kg) = Height in cm – 105

Normal weight of a Male (Kg) = Height in cm – 100

1-3 Kgs above or below is fine this value is still Normal. However, if someone is

5-6 Kgs above is considered overweight.

10 Kgs+ is considered Obese with high chance of Type-2 Diabetes.

Once the body weight goes above 5 Kg it is important to start taking corrective steps and bring the weight to normal. If the person is unable to bring the weight under-control, he/she must visit a dietician.

How can one prevent Obesity & Obesity linked ailments like Diabetes?

Well to explain this let’s take the example of one of our patients who was over 100Kgs and was in a pre-diabetic stage before he came to us. Amit (name changed) is your typical 29 year old professional & a father of a 1 year old baby working 11am to 11pm. Staying close to his office he would get up by am, gets-up, eats his normal home cooked breakfast (in 5mins), then goes to the office and takes his home cooked lunch and also enjoyed his canteen food. In the evening around 5:30pm he would have a samosa or other fast-food. He would also have coffee from the inhouse coffee vending machine every few hours.  After going home at 11pm he would have his dinner and then go to sleep. This routine has been continuing for some years now. Eventually his weight jumped to almost 110 Kgs. Consequently, he would feel sleepy and tired most of the time. At times he would even douse off at work without even realising it. Concerned, he might dose off while sleeping let alone lose his job. His boss recommended him to visit a doctor. That’s when he came across Sweet Clinics.

When we did a complete body check-up for him we realised he was excessively overweight and had a high blood sugar level, cholesterol level. Based on the reports our in-house Obesity consultant Mrs. Pratiksha Kadam carefully analysed his daily lifestyle in detail. Knowing very well that he cannot change his work schedule. She suggested subtle lifestyle & dietary changes to bring his obesity in control.

1. Lifestyle Changes: She suggested Amit to get up a little early by 7-7:30 am and go for a walk for upto 1 hour. It’s not easy for a 100 Kg person to walk 1hour on the 1st day it-self. Amit was suggested to start by walking only for 5-10 mins then taking rest for 5-10mins. Progressing according to reach bigger milestones. At work he was asked to find ways that could help reduce his sitting hours, when possible. Try to take stairs instead of lifts when possible. That’s It!
2. Dietary Changes: Amit was a foodie and he truly enjoyed what he ate, in fact he loved it so much he would gulp it down in minutes. The first thing he was asked to do was take atleast 30 min to finish his food. He was also suggested subtle changes in his eating habits, like
   1. At lunch he was to have only what he had got from home and not combine it with canteen food.
   2. Amit used to drink a lot of coffee to stay awake. However, once he started his weight reduced coupled with the morning walk his dependency on it reduced. He was further advised to try replacing his evening coffee with chaas (which is more nourishing and the probiotics keep the stomach healthy). Doing this also made him less hungry in the evening which further restricted his evening snacking.
   3. He was asked to have his dinner at work around 8pm and after reaching home at 11 in the night.
   4. He was already having a good nutritious breakfast so no changes were made there

Just by following these subtle changes he was able to reduce his weight from 110 to 80 in just 6-8 months. His blood sugar levels were back to normal and he significantly reduced his chances of diabetes and other ailments.

Obesity can easily be brought in check by just being awareness of one’s actions and making the right choices. One can shed the extra weight by making subtle changes in one’s life like, going for a stroll for an hour at-least and being more mindful of when and what they eat.

At times people are not sure how to go about the change or are unable to reduce their weight even by improving their eating habits. At such times its best to visit an obesity consultant who can understand in detail the daily lifestyle and eating habits. Hence, identifying why the person is not able to reduce weight. Consequently, guiding the person on what changes to make in his eating and life to bring about the change he/she wants… i.e. to lose weight and prevent obesity related complications.