Skip to main content
Submitted by Dr S. Patel on 25 November 2021

Persons with diabetes have a 2-to-3 fold higher rate of cardiovascular complications than those without diabetes. Read more about how diabetes increases the risk of complications and what can be done to manage this risk. Pro-tip: The best approach is to manage and control diabetes well. 

The diabetic population is known to have a 2-to-3 fold higher rate of complications than the non-diabetic population. While it is true that diabetes increases the risk of getting numerous complications, the risk can be significantly reduced by managing and controlling diabetes well.

Complications can not only be delayed but even prevented with timely control of the disease. Diabetes can affect several organs and systems in the body and can lead to serious health consequences. The damage to the heart and the vascular system is of utmost importance because it is the number one cause of death in diabetic patients.

The cardiovascular events caused by diabetes are primarily divided into three groups:

1.   Atherosclerosis

Atherosclerosis is the narrowing of the blood vessels in the body. This can be due to thickening of the vessel walls or fatty deposits along the lining of the vessels. As a result, less blood flow reaches the heart and its coronary arteries (arteries which supply the heart muscle) causing lack of oxygen to the heart muscle. This is called Coronary heart disease or Coronary Artery disease as part of the heart muscle stops functioning from no blood/oxygen supply.

Fatty plaque deposits due to high levels of bad cholesterol increases the formation of plaques or clots in the blood vessels. If a clot obstructs any of the coronary arteries, then it can cause heart attacks or myocardial infarcts. If the clot breaks off and reaches the brain, it can cause Stroke.

The stiffening of the blood vessels has a direct effect on increase of blood pressure thereby compounding the risk of cardiovascular events from sluggish blood flow. For more information on how Hypertension and Diabetes are connected, please read (link)

Signs and symptoms of Heart Attack to watch out for:

  • Chest pain or tightness
  • Pain on left arm, neck, jaw, or shoulder
  • Heartburn or discomfort
  • Difficulty breathing
  • Sweating
  • Tiredness
  • Dizziness
  • Nausea or vomiting

2.   Heart Failure

Heart Failure occurs when the heart overtime become too weak from low oxygen supply to be able to function properly. The pumping mechanism of the heart is decreased with low ejection fractions and the blood that travels to all the parts of the body is lessened. Heart Failure is a chronic and progressive complication of diabetes that can lead to heart enlargement, poor volume ejection and faster heart rate.

Signs/symptoms of Heart Failure that should be identified and reported:

  • Shortness of breath
  • Fast or irregular heartbeat
  • Nausea or vomiting
  • Coughing
  • Weakness
  • Fatigue
  • Swelling in the foot and ankles

3.   Cardiac Arrhythmias

Arrhythmias are irregular heartbeats. The rhythmic beating of the heart is controlled by electric firing. Changes in the heart structure or damage (such as a heart attack or heart failure) can cause disruptions in the rhythm causing the heart to beat faster, slower, or irregularly. Changes in blood glucose levels in diabetes along with obesity (including excess fat around the heart) are found to be the main contributors for cardiac arrythmias.

Arrythmias can be managed easily but if not detected on time can give rise to more chances of stroke and sudden cardiac death.

There are 5 types of Arrhythmias that can occur- Atrial Fibrillation, Ventricular Fibrillation, Supraventricular Tachycardia, Bradycardia and Heart Block.

Symptoms of Arrythmia that should be brought to your doctor’s attention:

  • Shortness of breath
  • Palpitations
  • Dizziness
  • Fainting

How to reduce your risk?

Keep a check on your ABCs and make the correct lifestyle alterations to reduce your risk of getting cardiovascular diseases.

A = HbA1c to be below 7%
B= Blood pressure maintain normal around 120/80
C=Cholesterol, LDL levels should be less than 70

Lifestyle changes

  • Stop smoking and use of all tobacco
  • Reduce alcohol intake
  • Cut down on salt, sugar and saturated fat intake
  • Exercise regularly ( moderate workout of 150 minutes per week or intense workout of 75 minutes per week)
  • Be more physically active and reduce sedentary time
  • Lose weight if you are obese or overweight
  • Manage your stress
  • Take your medications as prescribed

Persons with Diabetes should see their doctor regularly and monitor their blood glucose, cholesterol and blood pressure levels frequently so as to avoid any complications and reduce their risk of getting a cardiovascular event. If they notice any signs and symptoms of a heart problem, they must seek medical attention immediately.

Issued as part of the public education series by Boehringer Ingelheim India and PatientsEngage

 

References:

Grisanti L. A. (2018). Diabetes and Arrhythmias: Pathophysiology, Mechanisms and Therapeutic Outcomes. Frontiers in physiology, 9, 1669. https://doi.org/10.3389/fphys.2018.01669
American Diabetes Association. Oct 2021 https://www.diabetes.org/diabetes/complications/cardiovascular-disease
National Health System of the UK. Oct 2021 https://www.nhs.uk/conditions/arrhythmia/

Changed
27/Dec/2021

Stories

  • Chickpea curry (6 portions)
    Chickpeas or garbanzo beans are rich in fibre, iron, phosphorus and the B-complex vitamins. It has been seen that eating chickpeas control blood sugar levels after meals, so it is good for people with diabetes. This recipe also uses poppy seeds, which are a good source of calcium and fibre, low in sodium and have no fat or cholesterol, as well as coconut, which provides certain essential fats missing from other vegetable oils. In this recipe they have been used in…
  • Paneer paratha (makes 6 portions)
    Paneer paratha is a favourite choice for kids’ lunchboxes. It is nutritious and can be modified for the needs of growing children by using whole-fat paneer instead of low-fat and an extra dash of fat (ghee, butter or oil depending on preferences).  Ingredients For the dough  200g whole wheat flour  2 tsp white oil  Pinch of chilli powder  Pinch of salt  For the Filling   200g low-fat paneer  100g onion  50g carrot Small bunch of coriander…
  • Diabetes Overview
    Diabetes - An Overview
    What is Diabetes or Diabetes Mellitus Diabetes Mellitus is a metabolic disorder in which the body has difficulty regulating its blood glucose or blood sugar level. Blood glucose is the main source of energy for the body and we get it from the food we eat which is broken down into glucose. For glucose to get into the cells, insulin, a pancreatic hormone is required. In patients with diabetes, the pancreas produces less or no insulin or the cells don’t respond to the insulin…
  • Diabetic Retinopathy FAQ
    Diabetic retinopathy is an increasing cause of blindness in persons with diabetes. Senior Ophthalmologist Dr Charu Gupta answers your questions, clears misconceptions and separates the facts from the myths. What is diabetic retinopathy? Diabetes can cause changes to the blood vessels of the retina, leading to blindness. This is called diabetic retinopathy. I have good eyesight. I don’t have to worry about diabetic retinopathy. Unfortunately that is not true. Many patients with severe…
  • Delicious Navratan Khichdi Recipe
    A nutritious navratan khichdi that is filling and provides excellent quality protein. It can be adapted to pongal as well. Its tasty and easy to make! Excellent quality protein, loads of vegetables. Great for persons with diabetes too. Ingredients (Serves 6 people) 225g rice  50g soya nuggets (If you skip this for a more traditional option it will reduce the protein content) 55g arhar (toor) dal 55g chana dal 55g moong dal 55g masoor dal 100g potatoes 100g carrot 100g cabbage 50g…
  • Chicken roast with apple sauce (6 portions)
    This preparation is a low-calorie modification of the typical roast. The initial tossing in oil reduces the chicken from drying out while in the oven. The apple sauce without sugar is highly recommended for those who wish to keep their sugar spikes under control after the meal. Ingredients  Whole dressed chicken – 1 ½ kg 4 apples 6-8 small onions 6 potatoes 4-5 carrots 20 French beans 1 capsicum 1 tsp ginger juice 1 tbsp soy sauce (optional) 2 tbsp Worcester sauce 1 stick cinnamon 10 to12…
  • Cheela - Vegetable Omelette Recipe
    This is a vegetable omelette with a difference. You can rustle up this omelette at the drop of a hat on a summer’s day when you don’t feel like having an egg. Ingredients (Makes 6 portions) ½ cup (60g) rice flour ¼ cup whole wheat flour 1 tbsp refined flour 2 tbsp besan ½ cup buttermilk or as required 1 onion (large), minced   1 tomato, chopped  3 green chillies, chopped Few curry leaves, chopped  Salt to taste ½ tsp mustard seeds Pinch of cooking soda (optional) 1 tbsp oil…
  • Avocado In Lettuce Boats (6 servings)
    Elevated levels of blood sugar in diabetes increase the risk of elevated ‘bad’ cholesterol, triglycerides and other cardiovascular problems. Attempts to reduce these risk factors through medication and diet also reduce the level of ‘good’ cholesterol. Exercise and the presence of moderate amounts of monounsaturated fats in the diet help to increase ‘good’ cholesterol in our body. Avocado, also called “butter fruit” in some parts of India, is rich in monounsaturated fats and anti-oxidant Vitamin…
  • DOs & DON’Ts OF THE DIABETES DIET
    Diabetes management is not a one time fix. It requires sustainable lifestyle changes. Registered Dietitian and Diabetes Educator explains the dos and don’ts for eating well and keeping your blood sugar under control. Whether you have been recently diagnosed with diabetes or are a longstanding diabetes patient, your heart skips a beat while you’re waiting to see your blood glucose reading. You are keen to do all that it takes to bring down the blood sugar quickly – whether it is by omitting…
  • Your guide to low Glycaemic Index foods
    What is Glycaemic Index and why you need to be aware of it when planning meals - By Ujjwala Baxi, Registered Dietitian and Certified Diabetes Educator. What is Glycaemic Index? Mr. Ram and Mr. Raghu are brothers with diabetes. The breakfast menu is mostly the same for both. The only difference is that Mr. Ram likes to have his butter on white bread whereas Mr. Raghu prefers it on multigrain bread. They both leave for work. Within a couple of hours, Mr. Ram feels hungry while Mr. Raghu is…