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How Are Diabetes And Heart Disease Related

Heart Failure In Diabetes Mellitus

Heart Failure In Diabetes Mellitus

INTRODUCTION AND DEFINITION Diabetes mellitus (DM) increases the risk of heart failure (HF) independent of coronary heart disease and hypertension and may cause a cardiomyopathy. The term “diabetic cardiomyopathy” was initially introduced based upon postmortem findings in four diabetic adults who had HF in the absence of coronary heart disease [1]. Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause (eg, coronary heart disease, hypertension) [2,3]. However, the frequency with which this occurs is not well defined and there is some evidence that diabetic cardiomyopathy is uncommon in patients with type 1 diabetes in the era of intensive insulin therapy [4]. Issues related to HF in diabetic patients will be reviewed here. The prevalence of and risk factors for coronary heart disease among patients with DM and the evaluation and treatment of HF are discussed separately. (See "Prevalence of and risk factors for coronary heart disease in diabetes mellitus" and "Evaluation of the patient with suspected heart failure" and "Overview of the therapy of heart failure with reduced ejection fraction" and "Treatment and prognosis of heart failure with preserved ejection fraction".) EPIDEMIOLOGY There is a well-established association between diabetes mellitus (DM) and heart failure (HF) that is partly but not entirely linked to coronary heart disease and hypertension. Associations have also been reported between absolute blood glucose levels, glycemic control, and HF. Diabetes and HF — The Framingham Study firmly established the epidemiologic link between diabetes and HF [5]. The risk of HF was increased 2.4-fold in men and fivefold in women. Diabetes predicted HF independent of coexisting hypert Continue reading >>

Diabetes Increases Heart Attack Risk By 48%

Diabetes Increases Heart Attack Risk By 48%

"People with diabetes 48% more likely to suffer heart attack, researchers find," says The Guardian. Meanwhile, the Daily Mail reports that people with diabetes are "65% more likely to have heart failure than the rest of the population". Both stories are based on the most recent report of the National Diabetes Audit, which presents data from England and Wales on the complications that arise due to diabetes. Diabetes makes it difficult for the body to control blood sugar levels. High blood sugar levels can damage blood vessels and lead to range of complications, such as: angina – chest pain that results from a temporary restriction of blood supply to the heart retinopathy – where the retina (the light-sensitive layer of tissue at the back of the eye) is damaged foot ulcers, which in the most serious cases, require a section of the foot or lower leg to be amputated People with type 1 diabetes can also experience a dangerous complication called diabetic ketoacidosis where the body breaks down fat as an alternative source of fuel. Left untreated, diabetic ketoacidosis can be fatal. The National Diabetes Audit report highlights these complications, as well as deaths in people with diabetes. The audit confirms and quantifies these risks, and provides recommendations on how the NHS can benefit from addressing the complications of diabetes, and how this can improve the lives of people with diabetes. Who produced the report? The National Diabetes Audit is produced by the NHS Information Centre each year. It looks at diabetes care and outcomes throughout England and Wales. The portion of the report covered in the media specifically focuses on complications and deaths related to diabetes. The current report covers the eighth year of the audit, and is based on data from 2010-11. Continue reading >>

Heart Disease And Diabetes

Heart Disease And Diabetes

Heart disease is common in people with diabetes. Data from the National Heart Association from 2012 shows 65% of people with diabetes will die from some sort of heart disease or stroke. In general, the risk of heart disease death and stroke are twice as high in people with diabetes. While all people with diabetes have an increased chance of developing heart disease, the condition is more common in those with type 2 diabetes. In fact, heart disease is the number one cause of death among people with type 2 diabetes. The Framingham Study was one of the first pieces of evidence to show that people with diabetes are more vulnerable to heart disease than those people who did not have diabetes. The Framingham Study looked at generations of people, including those with diabetes, to try to determine the health risk factors for developing heart disease. It showed that multiple health factors -- including diabetes -- could increase the possibility of developing heart disease. Aside from diabetes, other health problems associated with heart disease include high blood pressure, smoking, high cholesterol levels, and a family history of early heart disease. The more health risks factors a person has for heart disease, the higher the chances that they will develop heart disease and even die from it. Just like anyone else, people with diabetes have an increased risk of dying from heart disease if they have more health risk factors. However, the probability of dying from heart disease is 2 to 4 times higher in a person with diabetes. So, while a person with one health risk factor, such as high blood pressure, may have a certain chance of dying from heart disease, a person with diabetes has double or even quadruple the risk of dying. For example, one medical study found that people with d Continue reading >>

Cardiovascular Disease & Diabetes

Cardiovascular Disease & Diabetes

The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. Why are people with diabetes at increased risk for CVD? 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, may have the following conditions that contribute to their risk for developing cardiovascular disease. High blood pressure (hypertension) High blood pressure has long been recognized as a major risk factor for cardiovascular disease. 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 cardiovascular disease 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. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity Obesity is a major risk factor for cardiovascular disease Continue reading >>

Many Indians Are Prone To Heart Disease More Than Other Global Counterparts. What Makes Us More Prone? Any Suggestions Regarding The Preventive Measures?

Many Indians Are Prone To Heart Disease More Than Other Global Counterparts. What Makes Us More Prone? Any Suggestions Regarding The Preventive Measures?

Heart disease is more common among South Asians (read Indians), and also it tends to come at a younger age. Come to our ICCU and you would see couple of 35 to 45 aged young men, admitted with Heart attack. A decade back the anxious son used to wait outside the ICCU asking us about how his father is doing after a Heart attack; now in a turn of fortune, the father spends sleepless nights outside the Cath Lab, worrying about the condition of his son after angioplasty. The Westerners just are unable to digest and explain as to why we get heart attacks so often and at a younger age. Genes Yes, genetic factors are important. Though no single gene has ever been implicated, a strong family history still remain a major risk factor for heart disease, making us believe that there is indeed a genetic connection. Environment Before commenting on a genetic background for heart disease even when a number of members in the same family suffer from heart disease, consider that they tend to share a same environment. In a family where people eat lots of junk food, no one exercises and no one is health conscious, it is likely that any other member of that family also will have metabolic diseases related to lifestyle problems. Q. Do we get more heart disease in India? A. Yes Q. Why? A. We aren’t sure. What do we do to prevent Heart disease? Don't Smoke, Exercise regularly, have a healthy diet rich in fruits and vegetables, check and control diabetes, cholesterol and Blood pressure. Despite all the medical advances it is still not possible to change our parents - so stop worrying about family history of Heart disease! Edit : Thanks Akshay Kini for pointing out that we are South Asians. It was a Typo. Continue reading >>

Understand Diabetes & Cardiovascular Disease

Understand Diabetes & Cardiovascular Disease

Diabetes and cardiovascular disease often go hand-in-hand. Adults with diabetes are two to four times more likely to develop heart disease or have a stroke than people without diabetes. In fact, about 68 percent of people with diabetes die of heart disease or stroke - one more factor that makes cardiovascular disease the most common cause of death in both men and women. In addition, people with diabetes often have a build-up of atherosclerotic plaque throughout the body. About one in three people with diabetes over the age of 50 has peripheral artery disease (PAD), which is the narrowing of blood vessels by plaque in parts of the body other than the heart, for example in the legs or the kidneys. Continue reading >>

Blood Relatives: Diabetes And Heart Disease

Blood Relatives: Diabetes And Heart Disease

You may not think of diabetes as being a heart health issue. But diabetes is a key risk factor for heart disease. And the American Heart Association reports that people with diabetes are two to four times more likely to have heart disease. “There is a very strong relationship between diabetes and heart disease,” says Saadeddine Dughman, MD, cardiologist at Advanced Cardiovascular Institute, a Premier Health Specialists practice. “They are so interrelated that the National Cholesterol Education Program puts diabetes on their list equivalent to heart disease. Meaning, if someone has diabetes then we automatically look at them as if they already have heart disease.” He adds that people who have diabetes also are more likely to have other common heart disease risk factors, such as high cholesterol and high blood pressure. High blood sugar can damage blood vessels and arteries, over time, contributing to these problems. About 65 percent of people with diabetes die from some form of heart disease or stroke. And for people with type 2 diabetes, in which the body gradually loses the ability to use and produce insulin, heart disease and stroke are the leading cause of death and disability. The Good News: Diabetes is Controllable Diabetes is one of seven controllable heart disease risk factors. The others are high blood pressure, high cholesterol, physical inactivity, obesity, poor diet and tobacco use, according to the American Heart Association and the American Diabetes Association. Here’s how to lower your risk of diabetes — and heart disease: Eat right. A dietitian or diabetes educator can help develop a meal plan just right for you. You’ll need to cut back on total calories, limit the amount of processed or refined carbohydrates you eat, eat foods low in satura Continue reading >>

Diabetes And Heart Disease

Diabetes And Heart Disease

Tweet Heart disease is a complication that may affect people with diabetes if their condition is not managed well for a prolonged period of time.. Coronary heart disease is recognized to be the cause of death for 80% of people with diabetes, however, the NHS states that heart attacks are largely preventable. [48] How are heart disease and diabetes linked? People suffering from type 1 and type 2 diabetes are more likely to be at risk from heart attacks, strokes and high blood pressure. Vascular problems, such as poor circulation to the legs and feet, are also more likely to affect diabetes patients. Like diabetes itself, the symptoms of cardiovascular disease may go undetected for years. A Diabetes UK report from 2007 estimates that the risk of cardiovascular disease in people with diabetes is: [1] 5 times higher in middle aged men 8 times higher in women with diabetes. More than half of type 2 diabetes patients will exhibit signs of cardiovascular disease complications at diagnosis. Who does heart disease affect? Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30. Both type 1 and type 2 diabetics are at greater risk of developing heart disease. What is the cause of heart disease amongst diabetics? Hyperglycemia, which characterises diabetes, in combination with free fatty acids in the blood can change the makeup of blood vessels, and this can lead to cardiovascular disease. The lining of the blood vessels may become thicker, and this in turn can impair blood flow. Heart problems and the possibility of stroke can occur. What symptoms can identify heart disease? The following are common symptoms of heart disease, although this may vary from individual to indiv 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 >>

Heart Disease & Stroke

Heart Disease & Stroke

People with diabetes are at very high risk of heart disease and stroke, also known as cardiovascular disease (CVD) and cerebrovascular disease. People with diabetes may develop heart disease 10 to 15 years earlier than individuals without diabetes. Coronary artery disease is the most common form of heart disease in diabetes. It develops when the arteries that supply the heart with blood become narrowed or blocked by fatty deposits. This process is often called “hardening of the arteries.” If the arteries that supply the brain are hardened , this may lead to a stroke. High blood glucose (sugar) is one risk factor for heart attack or stroke, but people with diabetes often have a number of other risk factors. These include being overweight (especially if they have excess fat around the waist), inactive lifestyles, high blood pressure and high cholesterol. People who smoke or have a family history of heart disease or stroke are at even higher risk. Reducing risk Protect your heart with our vascular protection self-assessment tool. The good news is that people with diabetes can lower their risk of heart disease and stroke considerably by paying careful attention to all of their risk factors. Working with your health-care team to achieve the following targets is the key to good diabetes management. Achieving and maintaining a healthy weight through regular physical activity and healthy eating are important, but most people with diabetes will also require a number of medications to reach these goals. Do you know your ABCDEs? Ask your doctor about the ABCDEs to REDUCE your risk of heart attack and stroke: A – A1C – Glucose control target is usually seven per cent* or less (A1C is a blood test that is an index of your average blood glucose level over the preceding 120 da Continue reading >>

Health & Wellness

Health & Wellness

People with diabetes are at high risk of developing heart disease. Despite knowing this, scientists have struggled to trace the specific biology behind that risk or find ways to intervene. Now, UNC School of Medicine researchers have hunted down a possible culprit – a protein called IRS-1, which is crucial for the smooth muscle cells that make up veins and arteries. According to a study published in the Journal of Biological Chemistry, too little of IRS-1 causes cells to revert to a “dedifferentiated” or stem-cell like state, and this may contribute to the buildup of plaque in the heart’s arteries, a condition known as atherosclerosis, which increases the risk of heart attack, stroke, and other forms of heart disease. “When diabetes is poorly managed, your blood sugar goes up and the amount of this protein goes down, so the cells become subject to abnormal proliferation,” said senior author David R. Clemmons, MD, Sarah Graham Kenan Professor of Medicine at the UNC School of Medicine. “We need to conduct more studies, but we think this cell pathway may have significant implications for how high blood glucose leads to atherosclerosis in humans.” “When diabetes is poorly managed, your blood sugar goes up and the amount of this protein goes down, so the cells become subject to abnormal proliferation,” said senior author David R. Clemmons, MD The research could bring scientists one step closer to finding drugs to help stave off heart disease in people with diabetes, who are twice as likely to have heart disease or experience a stroke, as compared to people without diabetes. People with diabetes also tend to experience major cardiac events at a younger age. The study focused on the cells that form the walls of veins and arteries, known as vascular smooth m Continue reading >>

Diabetes Dilemma: The Connection Between Diabetes And Heart Disease

Diabetes Dilemma: The Connection Between Diabetes And Heart Disease

I like knowing why things are the way they are. Understanding the underlying causes of heart problems and treating them is one of the reasons I love working in cardiology. Sometimes the causes are obvious. Sometimes they’re not. For many people, the connection between diabetes and heart disease falls into the latter category. In fact, my wife and I talked about that just the other day over breakfast. She pointed out that people might take better care of themselves if they understood how the two conditions are connected. And I agree! The heart risks of diabetes If you have Type 1 or Type 2 diabetes, you’re more likely to develop heart disease than someone who doesn’t have diabetes. The Centers for Disease Control and Prevention (CDC) says adults with diabetes are two to four times more likely to die of heart disease or have a stroke than adults who don’t have diabetes. There are a few reasons for this higher risk in diabetes patients: Fluctuating levels of blood sugar, or glucose, which can damage the interior surfaces of blood vessels Potentially higher levels of lipids, or fats, in the blood, including high cholesterol levels (a condition known as diabetic dyslipidemia, which is associated with heart disease) A wide range of reactions specific to their type of diabetes, including elevated hormones and cytokines (proteins that cells use to communicate and carry out vital functions) These factors often result in accelerated atherosclerosis, or thickening of the walls of the arteries. But these aren’t the only ways patients with diabetes may be at greater risk for heart disease. Obesity, which often is a problem for patients with Type 2 diabetes, only makes these issues worse. Obese patients are more likely to have high blood pressure on top of their elevated ri Continue reading >>

The 411 On Heart Disease + Diabetes

The 411 On Heart Disease + Diabetes

Last month, we launched a new series on diabetes complications. The idea is definitely not to use scare tactics to convince you to take better care of yourself, but rather to embrace the notion that "knowledge is power" and that if you are diagnosed with a complication, life goes on... (Hey, we're facing our own worst fears here, too) It just so happens that February is National Heart Month (go figure), so this month we're focusing on that nasty thing that can happen to your heart with diabetes: cardiovascular disease. Our expert help is Dr. Robert Eckel, an endocrinologist and past president of the American Health Association. Not only is he a professional expert, he's also had type 1 diabetes for the past 50 years! PWDs are two to four times more likely to suffer with cardiovascular disease, so listen up! Like retinopathy, there are several types of cardiovascular disease, with their own symptoms and treatments: 1. Coronary artery disease: This is the first type of heart disease and is caused by narrowing or blocking of the blood vessels that travel to your heart via fatty deposits. If the blood vessels to your heart become partially or totally blocked, then the blood supply is reduced or cut off. When that happens, a heart attack can occur. Coronary artery disease can cause a heart attack. During a heart attack, symptoms include: chest pain or discomfort pain or discomfort in your arms, back, jaw, neck, or stomach shortness of breath sweating nausea light-headedness Dr. Eckel points out that due to nerve damage from diabetes, a heart attack could be painless, and you might not even know if you've had one. Scary! If you have had a heart attack, your doctor may put you on a blood thinner, like aspirin, which can help reduce the chances of a second heart attack. 2. Hear Continue reading >>

Women, Diabetes, & Cardiovascular Disease

Women, Diabetes, & Cardiovascular Disease

As a woman with diabetes, you have plenty of company. About 13 million women have diabetes, that about one in 10 women over age 20—have diabetes. Other facts include: The average age of diagnosis for women is 55 years old Certain racial and ethnic groups are at higher risk for diabetes. These include African Americans, Hispanics, American Indians, Native Hawaiian-Pacific Islander, and Asian Americans. If you have diabetes, you probably know about the potential for eye and foot problems. But how much do you know about the most common complication of diabetes cardiovascular disease? The fact is, people with diabetes are up to four times more likely to develop cardiovascular disease than are people who do not have diabetes. Overall, women with diabetes have a 31% risk of heart disease or stroke Unfortunately, about one-third of women with diabetes do not know they have the disease. For all these reasons, Cleveland Clinic experts in diabetes and heart disease recommend that every woman have her blood glucose tested, particularly those women with a family history of diabetes. When you know you have diabetes based on the results of a blood test, you can take steps to manage your condition and live a longer, healthier life. Diabetes is a disease of the pancreas. Situated behind the stomach, the pancreas is the organ responsible for producing the hormone insulin. After food is eaten, it is broken down into glucose, the simple sugar that is the main source of energy for the body's cells. Insulin helps glucose enter the cells where it is converted to energy. In diabetes, the pancreas either cannot produce enough insulin, cannot use insulin correctly or both. When insulin does not function properly, glucose cannot enter the cells. As a result, glucose levels in the blood increas Continue reading >>

Why Is There An Increased Rate Of Heart Disease?

Why Is There An Increased Rate Of Heart Disease?

Diabetes puts you at risk of heart disease (even if you have ‘normal’ looking cholesterol and no symptoms). This is because diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely. Heart attacks and strokes are up to four times more likely in people with diabetes For this reason, often people with diabetes are on blood pressure lowering medications, often in combination Maintaining fitness with regular physical activity combined with some weight loss can help reduce high blood pressure Diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely. Maintaining fitness with regular physical activity combined with some weight loss can help reduce high blood pressure. Blood pressure lowering medications are often required for people who have diabetes. Symptoms Often people do not know they have heart disease until they develop symptoms like chest pain, shortness of breath, dizziness or excessive fatigue when walking or exercising. It is important to note that symptoms may be mild to severe and sometimes there may be none at all. Examples of some other warning symptoms may be: Arm or jaw discomfort Indigestion Weakness Nausea. If you think you are having a heart attack, phone 000 IMMEDIATELY. How can I reduce the risk? One of the most important things to do to reduce the risk of heart disease is to meet with your doctor and/or Credentialled Diabetes Educator to discuss your individual risk factors and how to reduce them. In general terms you can reduce the risk by: Being physically active Losing weight if you are overweight Not smoking Managing blood fats Managing high blood pressure Ta Continue reading >>

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