Diabetes And Heart

Diabetes & Heart

Conventional Cardiac risk factors… superimposed on the diabetic state … Hypertension Microalbuminuria Inactivity South Asian origin Dyslipidaemia Obesity … further accentuate atherosclerosis in the diabetic state…accounting for the excess Cardiac risk

Why does diabetes predispose to atherosclerosis? Metabolic abnormalities…in diabetes High blood sugar High lipid Insulin resistance Alter the normal function of 3 different cell lines ARTERY … and their destruction leads to atherosclerosis Endothelial cell Platelet Smooth muscle cell

Metabolic abnormalities…in diabetes

 

Heart Attack Which patient is at greater risk of future attack? An attack survivor A typical Type 2 diabetic

Risk Factors and C.H.D. Adapted from : Stamler; Diabetes Care,12,573 (1989) Cholesterol. Smoking. Hypertension .

Heart Attack Equal risk An attack survivor A typical Type 2 diabetic Without heart problem

Atherosclerosis in T 2 DM ~80% of all people with Diabetes dying 75% from coronary atherosclerosis 25% from cerebral or peripheral vascular disease >75% of all hospitalizations are for diabetic complications . National Diabetes Data Group. Diabetes in America. 2nd ed. NIH;1995.

~80% of all people with Diabetes dying

75% from coronary atherosclerosis

25% from cerebral or peripheral vascular disease

>75% of all hospitalizations are for diabetic complications .

Death after MI Herlitz J et al, Acta Med Scand 1988

Managing Diabetes : 4 Cardinal Rules for the Patient 1. Follow a healthy meal plan 2. Regular exercise 3. Take your medication 4. Test your blood glucose regularly

1. Follow a healthy meal plan 2. Regular exercise