Diabetes is often considered as a disease of high blood sugar but unfortunately, this is only half true as diabetes is actually a disease with many abnormalities in many body systems where high blood sugar is only a “surrogate marker” of the disease and what this means – diabetes is unless the diabetes is properly managed. It is a warning sign that many serious diseases of heart, kidney, brain, eyes etc. are likely to occur. By understanding that diabetes is essentially a multi-system disorder, it becomes possible to understand its myriad harmful effects.
In an interview with HT Lifestyle, Dr Kaushal Chhatrapati, Interventional Cardiologist, MD DM, FACC FSCAI FESC, explained, “Diabetes is associated with dysregulated cholesterol regulation. Dysregulated diabetes often results in elevated levels of the type known as “bad cholesterol” and LDL cholesterol. High levels of triglycerides. Both of these are toxic to the arteries and can cause blockages in the arteries. Long-term uncontrolled diabetes is associated with cholesterol deposits: in the heart arteries, the arteries that supply the brain and the arteries of the arms and legs. Heart attacks, strokes and limb claudication. What’s more unfortunate is that nearly half of heart attacks in diabetics are asymptomatic: they are “silent.”
He elaborated, “This means that these attacks go unrecognized and manifest only as heart attacks. A therapeutic opportunity to treat heart attacks is lost, because we don’t know when the attack happened! This is the most treacherous aspect, because heart attacks are ignored. And All the recent developments and triumphs of interventional cardiology cannot be applied to these attacks. For example, mild symptoms such as sweating, shortness of breath, discomfort or “acidity” should be taken seriously. A full-blown heart attack can present with deceptively mild symptoms.”
He highlighted that in some cases, diabetic patients have a large heart attack due to slight acidity, hand pain or slight sweating. “Diabetic cardiomyopathy” weakens the heart muscles, a condition that can be dangerous if not treated in time. With strict diabetes control and medications, this condition can be normalized.”
Asserting that diabetes is equal to the risk factor of heart attack, Dr. Kaushal Chhatrapati emphasized, “This means that all diabetic patients should be treated as if they already have heart disease. Therefore, all diabetics should always be on cholesterol-lowering medications. Such care reduces the incidence of heart attacks. Treating diabetes with medication alone is not enough. A healthy diet, exercise, weight control, abstinence from smoking, alcohol consumption and management of other disorders such as high blood pressure, thyroid, cholesterol, etc. should always be part of the diabetes management protocol. Diabetes is a lifestyle disorder, and it must be addressed not only by medication but also by fundamental changes in lifestyle.”
He added, “Here, it is also necessary to discuss the fact that when the blood sugar level is low, heart attacks can occur in diabetic patients when they take insulin or other drugs.” Similarly, low blood sugar episodes should be avoided. One way to do this is to choose new drugs to treat diabetes, which are less likely to cause low blood sugar. These new drugs also benefit the heart’s pumping and kidney function.”
Establishing that diabetes and heart disease are closely related, Dr Kaushal Chhatrapati concluded, “Metabolic problems in diabetes form a spectrum with mild sugar elevation at one end (so-called pre-diabetes) and the involvement of multiple systems, including the heart, at the other end. The strong link between diabetes and heart disease Because of the interrelationships, this branch of medicine has developed into a separate specialty, “cardio diabetes.” Suffice it to say, diabetes treatment must be tailored so that heart disease is completely prevented. Treatment. Cholesterol, heart disease, weight management, healthy diet, exercise, and “Diabetes should be expanded from just “sugar control” to management of all problems, including metabolic regulation. “Myopic” diabetes care should be limited to blood sugar values. The way to a holistic risk management program.”