How big a problem is Diabetes?
In the latest surveys, the prevalence of DM in India has risen to around 10%. But that is an average for the country, and South India is much worse off. The prevalence is close to 13% in Tamilnadu. And cities like Chennai, it’s almost 25%. That means 1 in 4 Chennaiites is Diabetic! Less than half of them are diagnosed. And to make matters worse, only a 1/3rd of the patients with Diabetes is treated, and of those treated, only 1/3rd of them have their sugars well controlled!
Why do so many people have Diabetes?
The rise in Diabetes is due to rapid urbanization, sedentary lifestyle, unhealthy diets, obesity, tobacco use and increasing life expectancy. These all lead to ‘insulin resistance’ which, in simple terms, is the inability of the body to manage blood sugar.
How does Diabetes affect your body?
When you have Diabetes, your risk of heart disease increases. This is also called coronary disease or cardiovascular disease (CVD) and can cause heart attacks and strokes. The prevalence of CVD is over 20% for diabetics, which is double than 11% for non-diabetics. That means 1 in 5 Diabetics have Cardiovascular disease.
How does Diabetes increase your risk of heart disease?
If you have high blood sugar levels over time, your blood vessels can start to get damaged, leading to serious heart complications. This is because, in Diabetes, your body cannot use all of this sugar appropriately, so more stick to the blood vessels and red blood cells. This build-up may block and also damage the vessels carrying blood to and from the heart. This can cause heart attack, heart failure and death. This is important to know since 2 out of 3 people with Diabetes die from a heart attack or stroke.
So are high sugars the only problem?
No. It’s not all down to blood sugars. Blood vessels also get damaged by high blood pressure and high cholesterol (blood fats). These two conditions have also grown rapidly in India, contributing to heart disease. So it is important that if you are being treated for Diabetes, your cholesterol and high blood pressure should be monitored and treated as needed.
How does Diabetes affect the treatment of heart disease?
Diabetes affects blood vessels in multiple spots. This makes it a more severe and complex disease. Many have had silent heart attacks even before they come to see us. This might have affected their heart function as well. Medications and stents are usually not good options in these cases. So, many of these patients will need to undergo heart surgery. Recent studies have shown that more than 50% of the patients in India undergoing heart surgery are diabetic. In addition, uncontrolled diabetic patients suffer from poorer outcomes to treatment, including an increased risk of infection.
How do I keep healthy and avoid heart surgery?
- Know your ABCs of Diabetes – A – A1c, B – Blood pressure and C – Cholesterol (Blood Fats) measured at least once a year. Ensure support and advice from your doctor to keep them within your target range.
- Stop smoking.
- Eat a healthy, balanced diet.
- Be physically active. Do some exercise regularly.
- If you are overweight or are obese, get support to lose some weight. Even losing a small amount makes a real difference to your heart and your Diabetes.
- Take your medication as prescribed.
Keeping as close as possible to your target HbA1c level helps protect your blood vessels and, in turn, the heart. Even mildly raised blood sugar levels can, over time, put you more at risk.
So if you want to avoid heart surgery, you should keep your Diabetes well controlled.
Dr Nikhil Pollo Jaik Theckumparampil
Consultant – Minimally Invasive & Robotic Cardiac Surgery
Apollo Speciality Hospital, Vanagaram, Chennai