Diabetes mellitus is a mounting public health concern in Bahrain. Recent official figures claim that diabetes affects approximately 16.2 per cent of the adult population here. This means that roughly one in six adults in Bahrain suffer from diabetes and are at risk of cardiovascular effects of diabetes.
Diabetics tend to develop heart disease at a younger age and are two to four times more likely to die from heart disease than those without diabetes. The longer you have diabetes, the higher the chances of developing heart disease. This is because high blood sugar levels steadily attack the lining of your arteries and cause cholesterol deposition. This process leads to hardening of the coronary arteries supplying blood to the heart muscle, and eventually to angina and heart attack.
People with diabetes are also at increased risk for heart failure due to weakening of the pumping capacity of the heart. This is a serious medical condition and may cause fluid to retain in the lungs causing difficulty in breathing and in the legs causing swelling of the feet and ankles.
The typical symptoms of a heart attack include, chest discomfort or heaviness triggered by physical activity or stress, pain in one or both arms, pain in the shoulders or jaw or throat, acute shortness of breath and excessive sweating. In a diabetic persons, heart attack can occur without these classic symptoms. Atypical symptoms include nausea/ vomiting, restlessness/ confusion, abdominal pain or discomfort, bloating sensation of the abdomen, heartburn/ indigestion and feeling faint or dizzy.
Presence of other risk factors multiplies your chances of developing heart disease. For example, a person with only diabetes may have a certain likelihood of dying from heart disease; but, in a person with both diabetes and high blood pressure, the risk is doubled or even quadrupled.
Similarly, high levels of LDL cholesterol can lead to clogged blood vessels, raising the risk of developing heart disease. Diabetics can also have abnormal levels of another type of blood fat, triglycerides, which also can raise your risk of heart disease.
Moreover, being overweight or obese not just affects the ability to manage your diabetes well, but also increases the risk for heart disease and high blood pressure. You are at increased risk of heart disease if the waist measures more than 40 inches in a man and 35 inches in a woman. Another factor is smoking which, in any case accelerates the narrowing of the blood vessels, but in diabetes, the risks of heart disease are much higher.
Another concern is family history of heart diseases, and if you have diabetes plus family history, it’s even more important to take steps to protect yourself.
Reducing your risks:
With proper care and treatment, you can decrease your risk of having a heart attack or developing heart disease.
Eat a healthy, balanced diet to protect your heart with more of fruits and vegetables and less red meat and saturated fats.
Stop smoking. This could be the single most important step towards protecting your heart. If you need help stopping, ask your physician.
If you’re obese/overweight, try to reduce to your ideal body weight. Losing just a few kilograms can help control your diabetes better and reduce the chances of dying from heart disease.
Be physically active. 30 to 45 minutes of regular exercise is recommended. This may be walking, running, swimming or any of your favourite sport.
Get regular health checks. Get your HbA1c (averaged blood glucose), blood pressure and blood cholesterol measured regularly and keep these under control as per your physician’s advice.
Take your medication as prescribed. Statins are medicines that are used to reduce the cholesterol in your body. These can greatly reduce the risk of having a heart attack or stroke in people with diabetes. Talk with your doctor to find out if you need to take a statin.
In short, by managing diabetes and associated risk factors along with a healthy lifestyle, the devastating complications of heart disease can be prevented or delayed.
Dr Abdul Azeez is an interventional cardiologist at Bahrain Specialist Hospital