We all know that diabetes affects sugar metabolism. But what many people don’t know is that people with diabetes are at a far higher risk of heart disease. Adults with diabetes are two to four times more likely to die from heart disease. At least 68% of people older than 65 with diabetes will die from heart disease.[1] For National Diabetes Month, take a moment to learn about the connection between diabetes and the heart.
A common form of diabetic heart disease is coronary heart disease. In coronary heart disease, plaque collects on the walls of the arteries that bring blood to the heart. The plaque buildup narrows the blood vessel, restricting blood flow.[2] This can lead to chest pain and heart attacks.[3] Another type of diabetic heart disease is cardiomyopathy: a thickening and stiffening of the heart muscle, restricting the ability of the heart to pump blood.[4] Cardiomyopathy is a major cause of heart failure.[5]
So why are diabetics so vulnerable to heart disease? The answer is complex and multifaceted.[6] When a patient’s diabetes is badly managed, long periods of high blood sugar can damage blood vessels and accelerate heart disease.[7] The chronic inflammation that characterizes diabetes also contributes to heart disease.[8]
Another reason diabetes and heart disease are so tightly linked is that they may both emerge from the same cluster of risk factors.[9] Obesity, high triglyceride levels, high HDL cholesterol levels, high blood pressure, and high fasting glucose levels are all part of metabolic syndrome, which contributes to both diabetes and heart disease.[10]
As a healthcare provider, make sure your patients understand these connections and what they can do about it. The American Heart Association considers diabetes to be one of seven major controllable risk factors for cardiovascular disease.[11] The key word here is “controllable.” By exercising, eating healthy, and managing their weight and blood glucose, patients with diabetes can avoid or delay the development of heart disease.[12]
Diabetes and heart disease are both examples of chronic disease: a condition lasting more than a year, and requiring ongoing medical care or limiting activities of daily life. Chronic disease is on the rise—six in ten Americans lives with a chronic disease.[13]
From physical health to emotional, social, and cognitive health, chronic disease is complex to manage.[14] But nurses have a special role in the battle against chronic disease. Nurses are the largest workforce in the healthcare, and often have close and long-term relationships with the patient, family, and community. This means that the nurse is perfectly poised to partner with patients in treating chronic disease.
Here are the ways to help your patients understand and manage their diabetes:
- Educate your patients about the connections between diabetes and heart disease. Despite how common diabetic heart disease is, many patients with diabetes have no idea that they have an elevated risk of heart disease.
- Screen yearly for all risk factors of heart disease. In some patients, heart disease first presents as elevated cholesterol levels. In others, high blood pressure may be the first warning sign.[15]
- Encourage lifestyle changes. Help your patients create healthy meal plans, and talk to them about the benefits of exercise.[16]
- For patients who smoke cigarettes, smoking cessation is key. People with diabetes who smoke are much more likely to have serious health issues from diabetes.[17]
- Consider medication for heart disease. Statins or Aspirin can lower some patients’ risk of heart disease.[18]
Sources
[1] http://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease–diabetes
[2] https://medlineplus.gov/coronaryarterydisease.html
[3] https://medlineplus.gov/coronaryarterydisease.html
[4] https://health.clevelandclinic.org/diabetic-cardiomyopathy-5-tips-for-cutting-your-risk/
[5] https://my.clevelandclinic.org/health/diseases/16841-cardiomyopathy?_ga=2.47253543.1441191425.1542862496-1264230567.1542862495
[6] http://spectrum.diabetesjournals.org/content/21/3/160
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674740/
[8] https://www.sciencedaily.com/releases/2016/11/161102080309.htm
[9] http://www.heart.org/en/health-topics/metabolic-syndrome/why-metabolic-syndrome-matters
[10] http://www.heart.org/en/health-topics/metabolic-syndrome/why-metabolic-syndrome-matters
[11] http://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease–diabetes
[12] http://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease–diabetes
[13] https://www.cdc.gov/chronicdisease/about/index.htm
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376024/
[15] https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/cardiovascular-disease/cvd_whatisthelink_updated_11-17d56ee436a05f68739c53ff0000b8561d.pdf?sfvrsn=4
[16] https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke
[17] https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html
[18] http://care.diabetesjournals.org/content/41/Supplement_1/S86