Health Resource Center
Diabetes and Heart Disease
Aug 20th 2008
Diabetes
is a group of diseases characterized by high levels of blood glucose resulting
from defects in insulin release, insulin action or both. Almost 800,000
Americans are diagnosed with diabetes each year. Nearly 16 million Americans
suffer from this disease today. Insulin regulates the body’s use of sugar and
allows the sugar in the body to be metabolized for immediate energy needs. If
not immediately needed, the sugar is then stored for future use. If glucose is
not immediately used or stored, levels build up in the blood stream. Elevated
blood sugar is harmful to the body.
The most common forms of diabetes are Type 1 (insulin
dependent) and Type 2 (non-insulin dependent). Type 1 diabetes accounts for
between 5 and 10 percent of all cases and is caused mainly by genetic factors
causing the body to destroy the insulin producing cells in the pancreas. Thus,
the body does not produce enough insulin and therefore additional insulin must
be used to treat this disease. Type 2 diabetes accounts for 90 to 95 percent of
all cases. Risk factors for Type 2 diabetes are increased age, obesity, family
history of diabetes, and physical inactivity. African Americans, Hispanic
Americans and American Indians are at increased risk for Type 2 diabetes. In
Type 2 diabetes, the pancreas produces enough insulin but the body’s cells are
resistant to the actions of the insulin and may ignore it altogether. Type 2
diabetes may often be treated with pills that help to lower blood sugar levels.
In severe cases, extra insulin is needed. Symptoms of diabetes are excessive
thirst, hunger and urination. In Type 2 diabetes, these symptoms may be less
severe or absent. Often patients are just fatigued and tired. Tingling in the
hands and feet are common due to nerve damage from excess sugar levels. The
American Diabetes Association recommends a fasting blood sugar in all patients
at age 45 years and if normal every 3 years thereafter.
Unfortunately, diabetes can be associated with serious
complications and early death. The death rates are twice as high among
middle-aged people with diabetes as the same population without the disease.
People who have diabetes that goes undetected and untreated face an increased
risk for heart disease and vascular disease (disease of the blood vessels)
because narrowing of the arteries occurs more quickly, more severely and at an
earlier age. Diabetes is also associated with increased blood levels of
triglycerides, decreased levels of HDL (good cholesterol), and high blood
pressure. These are all associated with increased heart and vascular disease.
Blockages (atherosclerosis) in the arteries supplying blood to the heart
(coronary arteries) may cause chest pain and heart attacks. Blockages in the
arteries supplying blood to the legs can cause pain when walking (claudication)
and may lead to loss of a limb (more common in diabetics). Blockages in the
arteries supplying blood to the arms may cause pain when using the arms and
blockages in arteries supplying blood to the brain (carotid arteries) may lead
to a stroke. The risk of stroke is 2 to 4 times higher in diabetics. Diabetics
are also at higher risk for undetected heart disease because often, blockages
of heart arteries are “silent” (without symptoms) because elevated blood sugar
may damage the nerves that allow a person to feel pain.
Early diagnosis and learning how to monitor and control
the disease is key to avoiding complications down the road. Important factors
are 1) adopting a good attitude, 2) commitment to doing what is necessary to
learn about the condition and its treatment, and 3) making a conscious decision
to control the disease and not allow the disease to control you. Diabetics
respond to a diet that reduces the intake of sugars and fats and increases the
intake of complex carbohydrates and fibers (nutrition education is important).
Weight loss, exercise (see your doctor before beginning vigorous exercise),
adequate blood pressure and cholesterol control are also essential.
If you are over 40 and notice any vague symptoms such as
fatigue, constant thirst, frequent and excessive urination, temporary blurred
vision, poor healing of cuts, excessive hunger, unexplained weight loss,
numbness and tingling of the toes and fingers, or if you are overweight,
schedule a physical examination as soon as possible. There is no cure for
diabetes, but with early detection, careful monitoring and treatment, and
patient commitment to healthy living, diabetics can avoid complications and
enjoy a long and active life.
