Diabetes is a much bigger threat to the heart! Know what new study says

A new study published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association, has found that 1 in 3 adults who already have type 2 diabetes might also have heart issues.

The study's findings strengthen the claims around diabetes and cardiovascular risk and how they are interlinked.

"Elevated levels of two protein biomarkers that indicate heart damage were associated with undetected or symptomless cardiovascular disease in adults with Type 2 diabetes compared to those without Type 2 diabetes," the study found.

The two protein markers are troponin T and N-terminal pro-B-type natriuretic peptide.

The study highlighted the need of non-statin therapies to treat heart diseases in those with diabetes.

“Cholesterol is often the factor that we target to reduce the risk of cardiovascular disease in people with Type 2 diabetes. However, Type 2 diabetes may have a direct effect on the heart not related to cholesterol levels. If Type 2 diabetes is directly causing damage to the small vessels in the heart unrelated to cholesterol plaque buildup, then cholesterol-lowering medications are not going to prevent cardiac damage,” study co-author Elizabeth Selvin, Ph.D., M.P.H., a professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore has said.

"Diabetes is a very important risk factor for developing heart disease, having diabetes means you are more likely to develop heart disease. Actually, people with diabetes are also more likely to have other risk factors which predispose to development of heart disease such as high blood pressure & high cholesterol that increases their chances of many fold of having a heart attack or a stroke. High blood glucose from diabetes can damage your blood vessels and nerves that control your heart and blood vessels," explains Dr Sanjeev Chaudhary, Director- Cardiology at Marengo Asia Hospitals, Gurugram.

"Over time this damage can lead to heart disease, this also leads to increased viscoelastic of the blood and more blockages in coronary arteries which supply blood to the heart and can lead to heart attack. People with diabetes tend to develop heart disease at younger age than people without diabetes," he adds.

The ABCD stands for A -A1C/HBA1C and is used to determine the severity of diabetes. The higher the A1C, the more likely it is that heart disease could arise. B is the blood pressure indicator; higher the blood pressure, the greater the risk for heart disease. C represents cholesterol; additionally, bad cholesterol is also one of the risk factors for heart disease and The letter D stands for lifestyle choices including diet, exercise & smoking, explains Dr.V. Mohan – Chairman and Chief Diabetologist – Dr. Mohan’s Diabetes Specialities Centre.

"As can be seen, many different factors can increase a person's chance of developing heart disease. If the HBA1C is kept under 7%, blood pressure should be kept below 140/90 mm mercury (Hg), which is at least the age-recommended amount. Ideally, the LDL cholesterol should be under 70 mg or 60 mg per deciliter, which is less than 100 mg," adds Dr Mohan.

"A person with diabetes should manage their blood pressure also, it is the force of your blood against the wall of your blood vessels so if your blood pressure gets too high it makes your heat work to hard and it also is a cause of heart attack or stroke and it can damage your kidneys and eyes," says Dr Chaudhary.

He recommends getting blood glucose checked everyday. "You can have regular blood glucose checks which should be done ideally everyday and we should also check our three month average blood glucose level which is done by the test which is known as HBA1C . The A1C goal for many people with diabetes is below 7 % so, we should manage our blood glucose," he says.

Dr V Mohan recommends few changes in lifestyle habits.

"The risk of heart disease can be significantly reduced even in those with diabetes if a balanced diet is maintained with lots of fruits and vegetables, especially those with green leafy vegetables, and less salt, sugar, and saturated fat," he says.

Heart disease can be prevented in several ways, including regular exercise—at least 30 to 45 minutes of brisk walking each day—yoga, pranayama, and other stress-relieving methods, he adds and recommends taking up a hobby.

"It is advised to make at least three to four visits a year to keep the ABC under control and keep an eye on the D, which stands for discipline and lifestyle actions," he recommends.

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The new study has suggested adding cardiac biomarkers troponin T and N-terminal pro-B-type natriuretic peptide to routine assessment of traditional cardiovascular risk factors which are high blood pressure and high cholesterol.

“The biomarkers analyzed in this study are very powerful in systematically categorizing patients based on their health status. Measuring biomarkers more routinely may help us focus on cardiovascular prevention therapies for people with Type 2 diabetes who are at higher risk,” Selvin said.

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