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Diabetes Mellitus Effects On The Cardiovascular System

The Pathophysiology Of Cardiovascular Disease And Diabetes: Beyond Blood Pressure And Lipids

The Pathophysiology Of Cardiovascular Disease And Diabetes: Beyond Blood Pressure And Lipids

In Brief The pathophysiology of the link between diabetes and cardiovascular disease (CVD) is complex and multifactorial. Understanding these profound mechanisms of disease can help clinicians identify and treat CVD in patients with diabetes, as well as help patients prevent these potentially devastating complications. This article reviews the biological basis of the link between diabetes and CVD, from defects in the vasculature to the cellular and molecular mechanisms specific to insulin-resistant states and hyperglycemia. It concludes with a discussion of heart failure in diabetes, a clinical entity that demonstrates many of the mechanisms discussed. Diabetes is a prime risk factor for cardiovascular disease (CVD). Vascular disorders include retinopathy and nephropathy, peripheral vascular disease (PVD), stroke, and coronary artery disease (CAD). Diabetes also affects the heart muscle, causing both systolic and diastolic heart failure. The etiology of this excess cardiovascular morbidity and mortality is not completely clear. Evidence suggests that although hyperglycemia, the hallmark of diabetes, contributes to myocardial damage after ischemic events, it is clearly not the only factor, because both pre-diabetes and the presence of the metabolic syndrome, even in normoglycemic patients, increase the risk of most types of CVD.1–4 In 2002, a survey of people in the United States with diagnosed diabetes found that, surprisingly, 68% of patients did not consider themselves at risk for heart attack or stroke.5 In addition, only about half of patients surveyed reported that their health care providers discussed the high risk of CVD in diabetes and what steps they could take to reduce that risk.5 Fortunately, we are now making the link. Health care providers are now focuse Continue reading >>

Diabetes And The Vascular System

Diabetes And The Vascular System

The vascular system carries oxygenated blood around the body The vascular system is made up of arteries and veins that carry oxygenated blood around the body and oxygen depleted blood to the lungs to remove carbon dioxide from the blood and replenish the oxygen. People with diabetes commonly experience problems with their vascular system and charity Diabetes UK notes that diabetes is associated with a 5 times higher risk of developing cardiovascular disease. What are the problems that can arise with the vascular system? Arteriosclerosis is the thickening and stiffening of the arteries this means that they become less flexible and create resistance for the blood that is moving inside them. Arteriosclerosis is thought to be caused by excess fat in the diet and high cholesterol. There are some schools of thought that have hypothesised that it is refined food and food rich in omega-6 fatty acids that leads to an inflammation of the endothelial cells that line the veins and arteries in the entire circulatory system. It is thought that this inflammation means that excess fat and cholesterol consumed binds easier to the artery walls forming hard plaque structures which result in the stiffening and in some severe cases blockages of veins and arteries. Coronary heart disease results if the build up of plaque on the inside of the arteries and veins that supply oxygen to and take away carbon dioxide from the heart . This causes the narrowing of the arteries and veins which means the heart isn't receiving enough oxygen as it is needed and it is being poisoned by excess carbon dioxide. High blood pressure can result from the heart trying to pump blood through narrowed arteries, although is has also been attributed to a diet high in salt, obesity, alcoholism and high stress levels. Continue reading >>

Effects Of Diabetes On The Body And Organs

Effects Of Diabetes On The Body And Organs

Over time, the raised blood sugar levels that result from diabetes can cause a wide range of serious health issues. But what do these health issues involve, and how are the organs of the body affected? Can these effects be minimized? When people have diabetes, the body either does not make enough insulin or cannot use what it has effectively. As a result, the amount of sugar in the blood becomes higher than it should be. Glucose, or blood sugar, is the main power source for the human body. It comes from the food people eat. The hormone insulin helps the cells of the body convert glucose into fuel. Fortunately, taking a proactive approach to this chronic disease through medical care, lifestyle changes, and medication can help limit its effects. Effect on systems and organs The effects of diabetes can be seen on systems throughout the body, including: The circulatory system Diabetes can damage large blood vessels, causing macrovascular disease. It can also damage small blood vessels, causing what is called microvascular disease. Complications from macrovascular disease include heart attack and stroke. However, macrovascular disease can be prevented by: Microvascular disease can cause eye, kidney, and nerve problems, but good control of diabetes can help prevent these complications. The cardiovascular system Excess blood sugar decreases the elasticity of blood vessels and causes them to narrow, impeding blood flow. The National Heart, Lung, and Blood Institute say diabetes is as big a risk factor for heart disease as smoking or high cholesterol. According to the Centers for Disease Control and Prevention (CDC), the risk of stroke or dying of heart disease increases by 200-400 percent for adults with diabetes. The nervous system When people have diabetes, they can develop n Continue reading >>

Diabetes In Cardiovascular Disease: A Companion To Braunwald's Heart Disease

Diabetes In Cardiovascular Disease: A Companion To Braunwald's Heart Disease

Diabetes in Cardiovascular Disease is a current, expert resource focusing on the complex challenges of providing cardiovascular care to patients with diabetes. Designed as a companion to Braunwald’s Heart Disease, this interdisciplinary medical reference book bridges the gap between the cardiology and endocrinology communities of scientists and care providers, and highlights the emerging scientific and clinical topics that are relevant for cardiologists, diabetologists/endocrinologists, and the extended diabetes care team. Access essential coverage of basic and clinical sciences, complemented by an expanded focus on epidemiology, behavioral sciences, health policy, and disparities in health care. Take advantage of a format that follows that of the well-known and internationally recognized Braunwald’s Heart Disease. Review the best available clinical data and pragmatic recommendations for the prevention and management of cardiovascular complications of diabetes; national/societal intervention strategies to curb the growing prevalence of diabetes; and the current pathophysiological understanding of cardiovascular comorbidities in patients with diabetes. Expert Consult eBook version included with purchase. Continue reading >>

Diabetes And Your Heart

Diabetes And Your Heart

If you have diabetes, you are more likely to develop coronary heart disease than someone without diabetes. Diabetes causes high levels of glucose in your blood. This is because of a problem with a hormone your pancreas produces called insulin. Insulin is responsible for moving glucose (a type of sugar) from your bloodstream and into the cells of your body for energy. If there little or no insulin being produced, or your body has become resistant to insulin, glucose stays in the bloodstream and can’t move across to your cells to give them energy to work properly. High levels of glucose in your blood can damage the walls of your arteries, and make them more likely to develop fatty deposits (atheroma). If atheroma builds up in your coronary arteries (the arteries that supply oxygen-rich blood to your heart) you will develop coronary heart disease, which can cause angina and heart attack. Types of diabetes Type one diabetes happens when your body cannot make insulin. This type most commonly affects children and young adults, and is a result of your body’s immune system attacking the cells that produce insulin in the pancreas. Type two diabetes occurs when your pancreas isn’t producing enough insulin or your body has become resistant to the insulin it’s producing. Type two diabetes is much more common than type 1 and tends to develop gradually as people get older – usually after the age of 40, but more and more people every year are being diagnosed at a much younger age. It's closely linked with: being overweight, especially if you carry weight around your middle being physically inactive a family history of type 2 diabetes. Some ethnic groups have a much higher rate of diabetes - particularly people of South Asian and African Caribbean origin. Diabetes and your he Continue reading >>

Are There Any Harmful Effects Of Insulin Therapy On Cardiovascular Outcomes In Diabetic Patients?

Are There Any Harmful Effects Of Insulin Therapy On Cardiovascular Outcomes In Diabetic Patients?

It is an apparently simple question, and one that clinicians face daily. Like many important clinical issues, this one is easy to ask but hard to answer. Even including the recently released U.K. Prospective Diabetes Study (UKPDS), no large randomized controlled clinical trial has been designed specifically to test the effect of insulin treatment on cardiovascular events. Such a study would be costly and would have to take into account many hard-to-control variables associated with type 2 diabetes. Also, the known adverse effects of poor diabetic control—from symptoms of hyperglycemia to worsening microvascular disease—weigh against initiating a study that intentionally withholds insulin therapy from those who need it to control glycemia. Without definitive proof of how insulin therapy affects cardiovascular disease (CVD), as many as 30–40% of people with type 2 diabetes now receive insulin . Based on average glycemic control , it could well be that even more people would benefit from its use. The persistent reluctance among many practitioners to start insulin can be attributed in part to the increased risk of hypoglycemia and insulin's unpopularity with patients. But the rationale often given is that insulin is atherogenic. Insulin, used therapeutically, is alleged to cause, rather than prevent, macrovascular disease. The reason for this concern is clear and is reviewed in this article. Some in vitro evidence suggests that insulin can promote lipid entry into atheromatous plaques and cause intimal hyperplasia. More impressively, a large body of evidence, though not entirely consistent, suggests that in the nondiabetic or prediabetic state, increased serum insulin (hyperinsulinism, or insulin resistance) is associated with increased incidence of CVD. There is also Continue reading >>

Type Ii Diabetes Mellitus And Cardiovascular Risk Factors: Current Therapeutic Approaches

Type Ii Diabetes Mellitus And Cardiovascular Risk Factors: Current Therapeutic Approaches

Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches 1 Department of Biological Chemistry, University of Athens, Athens, Greece 2 Department of Forensic and Investigative Science 4 Department of Biological Sciences, University of Central Lancashire, Preston, United Kingdom Correspondence: Prof Jaipaul Singh, Department of Biological Sciences, University of Central Lancashire, Preston, United Kingdom. E-mail [email protected] Received 2006 Jun 23; Accepted 2006 Jun 30. Copyright 2007, Pulsus Group Inc. All rights reserved This article has been cited by other articles in PMC. Worldwide, approximately 200 million people currently have type II diabetes mellitus (DM), a prevalence that has been predicted to increase to 366 million by 2030. Rates of cardiovascular disease (CVD) mortality and morbidity are particularly high in this population, representing a significant cost for health care systems. Type II DM patients generally carry a number of risk factors for CVD, including hyperglycemia, abnormal lipid profiles, alterations in inflammatory mediators and coagulation/thrombolytic parameters, as well as other nontraditional risk factors, many of which may be closely associated with insulin resistance. Therefore, successful management of CVD associated with diabetes represents a major challenge to the clinicians. An effective way of tackling this problem is to detect the associated risk factors and to target treatment toward their improvement. Targeting hyperglycemia alone does not reduce the excess risk in diabetes, highlighting the need for aggressive treatment of other risk factors. Although the current use of statin therapy is effective at reducing low-density lipoprotein cholesterol, residual risk remains for other independent lipi Continue reading >>

Diabetes Mellitus: A Major Risk Factor For Cardiovascular Disease

Diabetes Mellitus: A Major Risk Factor For Cardiovascular Disease

Abundant evidence shows that patients with type 1 diabetes or type 2 diabetes are at high risk for several cardiovascular disorders: coronary heart disease, stroke, peripheral arterial disease, cardiomyopathy, and congestive heart failure. Cardiovascular complications are now the leading causes of diabetes-related morbidity and mortality. The public health impact of cardiovascular disease (CVD) in patients with diabetes is already enormous and is increasing. Several explanations are behind this increase. First, the incidence of diabetes rises with advancing age, and the number of older people in the United States is growing rapidly. Second, insulin treatment for persons with type 1 diabetes has prolonged their lives significantly, and with each year of additional life comes an increased risk for CVD complications. Third, type 2 diabetes occurs at an earlier age in obese and overweight persons, and the prevalence of obesity is rising in the United States. The risk for diabetes in overweight persons is heightened by physical inactivity; unfortunately, the majority of Americans engage in little regular or sustained physical activity. Fourth, the populations that are particularly susceptible to diabetes—African Americans, Hispanics, Native Americans, Pacific Islanders, and Asians—are growing in this country. Fifth, improved medical care, particularly when extended to susceptible populations, will bring an increasing number of patients with type 2 diabetes into the medical care system. All of these factors will lead to an absolute increase in the number of patients who will require medical intervention to prevent the complications of diabetes. Diabetes has long been recognized to be an independent risk factor for CVD. Prospective studies, such as the Framingham, Honolulu Continue reading >>

The Effects Of Diabetes On Your Body

The Effects Of Diabetes On Your Body

When you hear the word “diabetes,” your first thought is likely about high blood sugar. Blood sugar is an often-underestimated component of your health. When it’s out of whack over a long period of time, it could develop into diabetes. Diabetes affects your body’s ability to produce or use insulin, a hormone that allows your body to turn glucose (sugar) into energy. Here’s what symptoms may occur to your body when diabetes takes effect. Diabetes can be effectively managed when caught early. However, when left untreated, it can lead to potential complications that include heart disease, stroke, kidney damage, and nerve damage. Normally after you eat or drink, your body will break down sugars from your food and use them for energy in your cells. To accomplish this, your pancreas needs to produce a hormone called insulin. Insulin is what facilitates the process of pulling sugar from the blood and putting it in the cells for use, or energy. If you have diabetes, your pancreas either produces too little insulin or none at all. The insulin can’t be used effectively. This allows blood glucose levels to rise while the rest of your cells are deprived of much-needed energy. This can lead to a wide variety of problems affecting nearly every major body system. The effects of diabetes on your body also depends on the type you have. There are two main types of diabetes: type 1 and type 2. Type 1, also called juvenile diabetes or insulin-dependent diabetes, is an immune system disorder. Your own immune system attacks the insulin-producing cells in the pancreas, destroying your body’s ability to make insulin. With type 1 diabetes, you must take insulin to live. Most people are diagnosed as a child or young adult. Type 2 is related to insulin resistance. It used to occur i Continue reading >>

Impact Of Diabetes On Cardiovascular Disease: An Update

Impact Of Diabetes On Cardiovascular Disease: An Update

Copyright © 2013 Alessandra Saldanha de Mattos Matheus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. 1. Introduction Diabetes is an important chronic disease which incidence is globally increasing and though considered as an epidemic [1]. The World Health Organization (WHO) estimated there were 30 million people who had diabetes worldwide in 1985. This number increased to 135 Continue reading >>

Diabetes, Heart Disease, And Stroke

Diabetes, Heart Disease, And Stroke

Having diabetes means that you are more likely to develop heart disease and have a greater chance of a heart attack or a stroke. People with diabetes are also more likely to have certain conditions, or risk factors, that increase the chances of having heart disease or stroke, such as high blood pressure or high cholesterol. If you have diabetes, you can protect your heart and health by managing your blood glucose, also called blood sugar, as well as your blood pressure and cholesterol. If you smoke, get help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.1 People with diabetes tend to develop heart disease at a younger age than people without diabetes. In adults with diabetes, the most common causes of death are heart disease and stroke. Adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes.2 The good news is that the steps you take to manage your diabetes also help to lower your chances of having heart disease or stroke. What else increases my chances of heart disease or stroke if I have diabetes? If you have diabetes, other factors add to your chances of developing heart disease or having a stroke. Smoking Smoking raises your risk of developing heart disease. If you have diabetes, it is important to stop smoking because both smoking and diabetes narrow blood vessels. Smoking also increases your chances of developing other long-term problems such as lung disease. Smoking also can damage the blood vessels in your legs and increase the risk of lower leg infections, ulcers, a Continue reading >>

Your Cardiovascular System And Diabetes

Your Cardiovascular System And Diabetes

Cardiovascular system is one of the most important systems in the human body. It is comprised of the heart, blood and blood vessels. Blood is being pumped out from the heart and is the one responsible in delivering oxygen and other nutrients to all the parts of the body. It also cleans up our body by picking up the waste products on its way back to the heart so our body can get rid of them. So what has diabetes got to do with the cardiovascular system? Since blood is part of the cardiovascular system, and diabetes is a condition in which the level of glucose in the blood is higher than normal, then there must be some relationship between the two. Diabetes and cardiovascular system diseases has been recognized to be closely related to each other for some time now due to the so-called insulin resistance syndrome or metabolic syndrome. Among the 20 million people in the United States who has diabetes, around 5 to 6 million of this population who are aged 35 years and above were diagnosed to have a certain cardiovascular disease according to the National Diabetes Surveillance System. Some examples of the commonly diagnosed cardiovascular disease are coronary heart disease, stroke, high blood pressure and other heart conditions. Cardiovascular diseases are the major cause now of deaths related to diabetes. In a study published few years back in the Journal of the American Medical Association, deaths due to some heart conditions went up by 23% in diabetic women despite the 27% drop of the same in non-diabetic women. As for diabetic men, there is only about 13% decrease in heart disease related deaths as compared to the 36% drop in non-diabetics. Thus, the two indeed go together. Risk Factors Diabetes is now considered by the American Heart Association a major risk factor in c Continue reading >>

Circulatory System And Diabetes

Circulatory System And Diabetes

The circulatory system is responsible for transporting blood around the body The circulatory system is responsible for the delivery of blood, and therefore glucose in the blood, round the body. The different complications of diabetes are a consequence of damage to blood vessels in different parts of the circulatory system. The circulatory system is essentially the body infrastructure, providing the route ways for the blood to transport oxygen, nutrients and hormones to and from the cells and organs. The heart plays a key role in the circulatory system, helping to pump blood around all the body. Blood vessels range in size, from larger arteries into very small blood vessels called capillaries. Capillaries feed into the veins which carry blood back to the heart. The circulatory system performs a number of roles, including: Delivering oxygen and nutrients, including glucose, to the bodys cells Carrying carbon dioxide and waste products away from the cells Transporting hormones and therefore helping the body communicate with its organs Transport white blood cells to fight off infection The circulatory system allows blood glucose levels to be regulated. The hormone glucagon, carried in the blood, signals the liver to release glucose into the blood and the presence of insulin in the blood instructs the cells to take in glucose from the blood. If blood glucose levels become too high for extended periods of time, damage can be sustained by the blood vessels. If significant numbers of blood vessels are damaged, this can have a negative effect on the functioning of the body. Where damage is sustained to a significant number of blood vessels in a certain area of the body, diabetic complications will develop. Neuropathy (nerve damage) results from damage to the blood vessels that Continue reading >>

Diabetes And Its Effects On The Cardiovascular System

Diabetes And Its Effects On The Cardiovascular System

Many people with diabetes are unaware of the complications that develop when diabetes is not well controlled. These include retinopathy, or damage to the retinas of the eyes, that can lead to blindness; neuropathy, or nerve damage; kidney failure, which can lead to dialysis; and cardiovascular disease. The term cardiovascular disease generally refers to diseases that include the heart and blood vessels. The latest statistics from the Texas Department of Health Services places diabetes as the sixth leading cause of death in Texas. The first and third leading causes of death in Texas are from heart attacks and strokes (cardiovascular diseases). In the Rio Grande Valley the death rate from diabetes is higher than in many other parts of Texas. It is also estimated that death from diabetes is underreported. Diabetes and its effects on the cardiovascular system is a slow and progressive process. If a diabetic person also has high blood pressure and abnormal lipids (high total cholesterol, high triglycerides, high LDL, and low HDL), which is a common finding in poorly controlled diabetics, the disease process is much more accelerated. The vessels that supply blood to the heart and the brain begin to stiffen, plaque develops inside them, and the blood supply to the heart and brain is greatly diminished. Decreased blood supply to the heart leads to symptoms of ischemia. A person may experience shortness of breath with activities, pressure–like chest pain, or feelings of fatigue. This can also lead to a heart attack and possible death. Sometimes signs of ischemia can be found on an–electrocardiogram (ECG or EKG) when the symptoms are more pronounced. A stress test almost always helps to determine if a patient has ischemia from narrowing heart vessels (coronaries). Adding smok Continue reading >>

Diabetes And Cardiovascular Disease: Epidemiology, Biological Mechanisms, Treatment Recommendations And Future Research

Diabetes And Cardiovascular Disease: Epidemiology, Biological Mechanisms, Treatment Recommendations And Future Research

Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research Benjamin M Leon, Department of Education, University of Colorado School of Medicine, Aurora, CO 80045, United States Thomas M Maddox, Cardiology 111b, VA Eastern Colorado HCS, Denver, CO 80220, United States Author contributions: Leon BM and Maddox TM organized, wrote and edited the review article. Correspondence to: Thomas M Maddox, MD, MSc, Cardiology 111b, VA Eastern Colorado HCS, 1055 Clermont St, Denver, CO 80220, United States. [email protected] Telephone: +1-303-3932826 Fax: +1-303-3935054 Received 2014 Oct 26; Revised 2015 Aug 2; Accepted 2015 Sep 16. Copyright The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. This article has been cited by other articles in PMC. The incidence of diabetes mellitus (DM) continues to rise and has quickly become one of the most prevalent and costly chronic diseases worldwide. A close link exists between DM and cardiovascular disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. Cardiovascular (CV) risk factors such as obesity, hypertension and dyslipidemia are common in patients with DM, placing them at increased risk for cardiac events. In addition, many studies have found biological mechanisms associated with DM that independently increase the risk of CVD in diabetic patients. Therefore, targeting CV risk factors in patients with DM is critical to minimize the long-term CV complications of the disease. This paper summarizes the relationship between diabetes and CVD, examines possible mechanisms of disease progression, discusses current treatment recommendations, and outlines future research directions. Keywords: Diabetes mellitu Continue reading >>

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