Diabetes and Heart Disease
Diabetes Mellitus is an elevation in glucose “sugar” levels in the blood. It is measured by a simple blood test. In adults, the prevalence of diabetes is associated with obesity. Individuals with diabetes have an increased in prevalence of coronary artery disease and should be evaluated by a cardiologist.
It’s a startling statistic- 80 percent of diabetics die of coronary artery disease. Patients with diabetes are much more likely to have heart disease, blood vessel disease, a heart attack or a stroke than a non-diabetic person. Heart disease is the leading cause of morbidity and mortality in the United States, and among diabetics, it is often more advanced and more pervasive. Commonly silent, heart disease often first manifests as a heart attack (acute Myocardial Infarction), acute Coronary Syndrome (ACS), or cardiac death. In diabetics, heart disease is more likely to show disease in more than one vessel at diagnosis. Among women, heart disease is the number one cause of death, and the nine million American women with diabetes are at an even greater risk. Health care professionals can take important steps to prevent, detect and treat heart disease in diabetic patients.
PREVALENCE OF DIABETES
Diabetes is an increasingly common disease in the United States, affecting an estimated 20.6 million American adults over the age of twenty. According to the American Heart Association (AHA), since 1990, the revalence of diabetes has increased more than 60 percent. That percentage will continue to grow. As the U.S. Department of Health and Human Services has reported, 40 percent of adults between the ages of 40 and 74 have pre-diabetes, a condition that significantly increases their odds of developing diabetes.
PATIENTS WITH DIABETES ARE MUCH MORE LIKELY TO HAVE HEART DISEASE, BLOOD VESSEL DISEASE, A HEART ATTACK OR A STROKE THAN A NON-DIABETIC PERSON.
RISK FACTORS
As a person’s risk for diabetes increases, so does their chance of developing heart disease. In fact, cardiac death rates are two to four times higher among diabetic adults than their non-diabetic counterparts. According to the American Diabetes Association (ADA), among persons with diabetes, the increased likelihood of coronary artery disease is associated with certain risk factors, including elevated cholesterol and blood pressure, a family history of premature heart disease, and smoking.
SCREENING FOR CAD
In addition to evaluating patients with signs or symptoms of heart disease, the ADA recommends screening diabetic patients in cases of sedentary adults over age thirty-five who wish to begin exercise programs or have a history of peripheral or carotid vascular occlusive disease. When heart disease is suspected or confirmed in the diabetic patient, further evaluation may include exercise myocardial perfusion imaging, echocardiography, and cardiac catheterization.
EIGHTY PERCENT OF DIABETICS DIE OF CORONARY ARTERY DISEASE.
MYOCARDIAL PREFUSION IMAGING (MPI)
MPI is a non-invasive nuclear imaging study to test for critical coronary stenosis. With improved diagnostic accuracy over regular stress tests, abnormal perfusion scans are highly indicative of coronary artery disease. MPI is used to determine the need for invasive procedures, avoid unwarranted hospital admissions or discharges, and to assess for long-term prognosis. MPI is a non-invasive test with high diagnostic and prognostic accuracy.
RISK REDUCTION
In addition to managing blood sugar, diabetes care also requires the management of blood pressure, cholesterol, and other cardiovascular disease risk factors. Risk reduction techniques include diet for weight management and glycemic control, smoking cessation, lifestyle and behavior modification to discourage sedentary habits, lipid reduction, and antiplatelet therapy. Early diagnosis allows aggressive secondary intervention proven to reduce morbidity and mortality.
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DR. STEVEN REISMAN, A NEW YORK CITY CARDIOLOGIST, DISCUSSES THE RELATIONSHIP BETWEEN DIABETES TYPE 2 AND HEART DISEASE
ONE IN THREE AMERICANS HAVE “PRE-DIABETES”.
DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE EFFECT OF DIETARY PROTEIN AND CONTENT ON WEIGHT GAIN DURING OVEREATING
