“It is unfortunate that if Diabetes is not controlled it will lead to heart problems.

Nearly nine out of ten patients of Diabetes will get heart ailments”, warns Dr. S.A. Merchant, a leading Interventional Cardiologist. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people.

If you are middle-aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.

Dr. Merchant, one of the leading cardiologist is attached to Leelavati Hospital, Saifee Hospital, Raheja Fortis Hospital, Umrao Hospital. With regular patients in Maharashtra & Gujarat and now from abroad- Middle East & East Africa specializes in the complete array of heart related problems including- Cardiac Catheterization and Angiography, Coronary Angioplasty with drug eluting stent, Valvuloplasties and TAVI ( Transfemoral Aortic Valve Implant), Carotid, renal and peripheral below knee stenting,, Permanent pacemaker implant and arrhythmia management, Soluble Scaffolding for Complex Coronary Artery Disease.

People with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition,heart attacks in people with diabetes are more serious and more likely to result in death.

High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).

Diabetes itself is a risk factor for heart disease and stroke. Also, many people with diabetes have other conditions that increase their chance of developing heart disease and stroke. These conditions are called risk factors. One risk factor for heart disease and stroke is having a family history of heart disease. If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.

You can’t change whether heart disease runs in your family, but you can take steps to control the other risk factors for heart disease listed here:

• Having central obesity
• Having abnormal blood fat (cholesterol) levels.
• Having high blood pressure.
• Smoking

It is appalling that nearly 15 per cent diabetics (1.5 crore diabetics) in India are below the age of 40 years. This staggering number is really alarming and is a warning bell for the development of appropriate diabetes and metabolic disorders, for such kind of young-onset type 2 diabetes.

Chart 1: Data- Age wise

In fact, diabetes has become a full-blown epidemic in India. In many parts of the world, diabetes spawned a host of problems like patients lacking care facilities and finding difficult to get insulin, blood pressure tablets and other medicines that avert risk of complications.

TYPE 2 DIABETES AMONG WOMEN
Worldwide, the rate of occurrence of Type 2 Diabetes is similar in both men and women, although they are slightly higher in men < 60 years of age and in women>65 years of age. It is said that 382 million people worldwide are living with diabetes and a big chunk of them are from lower and middle income groups.

However, as per the analysis in India concludes that 70% Indian men get appropriate diabetes treatment while only 30% Indian women are getting appropriate treatment.

Chart 2: Data- Gender

A startling revelation was made by the International Diabetes Federation regarding the number of diabetics in India. It said that an estimated 65 million adults with diabetes are there in India. And this number is set to soar to 109 million by 2035.

About 2/3rd diabetics (6.66 crore diabetics) in India have one or more comorbid coditions. Diabetics do not suffer from diabetes alone. A comorbid condition refers to one or more diseases or disorders that occur together with the primary condition or disorder.

Chart 3: Data- Comorbidity

The problem of diabetes in India is further compounded with about 50 per cent diabetics ( 5 crore diabetics) in India have high blood pressure

“Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure raises your risk for heart disease, stroke, and other problems.

Chart 4: Data- Blood Pressure

Nearly 15% diabetics (1.5 crore diabetics) in India have Hypercholesterolemia. Hypercholesterolemia is the presence of high levels of cholesterol in the blood. Hypercholesterolemia can contribute to many forms of disease, most notably cardiovascular disease. 80% diabetics (8 crore diabetics) in India have abnormal Cardiometabolic Risk Score.

Chart 5: Data – Cardiometabolic Risk

What is the Cardiometabolic Risk Score?

Diabetes and other risk factors could collectively lead to:

• Angina (Chest Pain)
• Myocardial Infarction (Heart Attack)
• Arteriosclerosis (Hardening of Arteries)
• Coronary Artery Disease (Heart disease)
• Atrial Fibrillation (Heart rhythm disorder)

60% diabetics (6 crore diabetics) in India have Autonomic Nervous System Dysregulation (Refer Chart 6 below)

The autonomic nervous system (ANS) controls a number of functions in the body such as heart rate, blood pressure, digestive tract peristalsis, and sweating, among others. Dysfunction of the ANS can affect these vital functions.

Autonomic Dysregulation could cause:

• Inability to alter heart rate with exercise
• Sweating abnormalities (too much sweat or insufficient sweat)
• Digestion difficulties (loss of appetite, bloating, diarrhea or constipation)
• Urinary problems
• Sexual problems
• Vision problems