| Ainul Huda Mohamed Saaid |
KUALA LUMPUR (Bernama) – Too much sweets can actually kill the heart! Cardiovascular disease remains the leading cause of death in diabetics.
According to National Health and Morbidity Survey 2011-2014, people with diabetes are two to four times more likely to have heart disease and five times more likely to suffer a stroke.
Consultant Endocrinologist Dr Wong Ming said diabetes by itself is now regarded as the strongest contributing factor for coronary heart disease (CHD).
Poorly controlled diabetes is just the beginning for more complications to come and patients with diabetes face CHD risk as high as 20 per cent within 10 years after being diagnosed with diabetes.
“Not only do people with diabetes have twice the likelihood of developing heart disease, they tend to develop heart disease at a younger age than people without diabetes,” said Wong.
Although there are technology and methods to diagnose CHD in its early stage, detecting symptoms of a heart attack within the diabetic group is still challenging due to a condition called Silent Ischemia.
Ischemia is a condition where the blood flow is restricted or reduced within a part of the body. Ischemia often causes chest pain or discomfort known as angina, which is the main symptom of a heart failure.
Silent ischemia is when people have ischemia without the pain.
Thus they have no prior warning to a heart attack. Among those who are at risk of developing this condition include those with previous heart attack and those with diabetes.
“The typical cardiac symptoms are often masked in people with diabetes resulting in missed or delayed diagnosis of a heart attack, thereby missing the chance for prompt revascularisation treatment,” she said during a roundtable discussion on diabetes and heart disease at Sunway Medical Centre recently.
Wong added hyperglycaemia (high blood glucose) and insulin resistance in diabetics drive the atherosclerotic process (plaque build up on artery walls).
“The sudden rupture of a cholestrol plaque is the common culprit especially among diabetics with co-existing dyslipidaemia (abnormal amount of fats or cholestrol in the blood), causing arterial blockage that may end up with a heart attack or stroke,” said Dr Wong.
At the same event, Consultant Cardiologist Dr Lim Bee Chian told participants that diabetics were exposed to vascular complications since the early stage of the disease.
Microvascular complications include eye problems that could lead to blindness, kidney failure, as well as damage to the nerve system, while macrovascular complications are namely stroke and heart disease.
For a doctor to get a comprehensive picture of the patient’s health and potential future risk and complications, their cardiometabolic risk have to be evaluated.
“Cardiometabolic risk is divided into two groups which are the non-modifiable factors; namely age, race, gender and family history, and the modifiable factors; like obesity, physical inactivity, unhealthy diet, abnormal lipid metabolism, insulin resistance, inflammation, hypertension and smoking.
“A holistic treatment will revolve around the modifiable factors, comprising of medication, lifestyle modification and physical activity,” explained Dr Lim.
Nowadays CHD diagnosis among diabetics are faster due to advances in medical care and increase in awareness. Improved diagnostic tools with greater accuracy are now widely available for earlier detection of atherosclerosis and early symptoms of CHD.
Among them is the Multislice Computed Tomography (MSCT) coronary scan.