Two out of three patients die of a cardiovascular event if they live with uncontrolled diabetes.
Dr. José García Mateo, endocrinologist and member of the Puerto Rican Society of Endocrinology and Diabetology. Photo: shutterstock
diabetes is an additional risk factor for someone heart disease, In addition, approximately 40% of patients with diabetes will have kidney complications and this increases the risk of heart disease,
This was noted by the endocrinologist Dr. José García Mateo in a previous program, “Alliance in Control.” diabetes“, led by the Journal of Medicine and Public Health, in which the doctor explained that heart failure is the most frequent cardiac complication, but it is not the only one.
“Of the heart complications we have emphasized the most in recent years, is heart failure. However, this does not mean that patients diabetes There are other major cardiovascular complications that do not need treatment, such as heart attack, stroke and peripheral vascular disease,” says the expert.
structural complications
The earliest complication of a patient living with heart failure is diabetes, The collective imagery, when talking about cardiac complications, is a heart attack, whether the patient has it or not. diabetes,
However, there are other factors that affect the lives of patients. diabetes, The fact that these patients already have risk factors for cardiometabolic syndrome puts them in stage A.
“That’s why the American Association of diabetesThe American College of Cardiologists, along with the American Heart Association, recommend patients with these diabetesregardless of whether they have symptoms or not, they can be assessed through tests that detect early structural complications before symptoms develop,” he recalls.
If there is a structural problem with the patient’s heart, that patient goes from stage A to stage B, and with that cardiologists can help with devices that prevent heart failure.
“Now, the American Society of diabetesIt is said that at least once a year we should evaluate the patients living with us. diabetes And do what they call BNP, and that’s a blood test. If that test is above 125, you already have structural changes, and that patient should probably be referred to a cardiologist,” he explained.
In this case, the cardiologist will perform an echocardiogram to check whether the patient has structural problems and how severe they are. Garcia adds that: “And if you have a heart that works properly, but it doesn’t fill well with blood and the tissues can’t get enough blood, or a heart that doesn’t beat properly because its ejection fraction is very low, and we stratify patients for more aggressive treatments, and for multidisciplinary treatment in cases that sometimes have no symptoms,” he explains.
heart failure
“Most of our patients are living with diabetes They have obesity, dyslipidemia, hypertension, lead a sedentary life with a poor diet. these are all risk Which leads us to a cardiac event where one of the earliest is not a heart attack, it’s not a stroke, it’s heart failure and the problem is heart failure (either preserved or low ejection fraction ), it is the most common and initial presentation of the patient living with diabetesAnd many of them are not diagnosed because the symptoms are non-specific,” he explains.
prior heart failure
As Dr. Garcia explains so well, it diabetes, in combination with hypertension or dyslipidemia, is already an indicator of heart failure. Furthermore, he comments that in recent years, heart failure has gained great importance among conditions associated with cardiac complications, explaining that patients with diabetes They can present other complications such as: “stroke, and peripheral vascular disease which increases the risk of disability because they have dissection, it can cause ulcer problems,” he says.
“If we only manage sugar for the patient, we are not doing it well. We must manage all the complications involved in cardiovascular events, whether it is glycemia management, blood pressure management, lipid management, weight management. And using the drugs in the right way is the beginning”, he stressed. “It’s just using the right drugs and individualizing therapy for each patient, depending on their complications.”
However, in light of this fact, it should be noted that “early glycemic control, in the long term, will reduce these cardiovascular problems,” Garcia says. Similarly, it is concluded that many patients are unaware and unaware that they have the disease.
