WORLD DIABETES DAY How to manage Type 2 diabetes & improve heart health

Dr Tilak Suvarna

While Diabetes Mellitus can adversely affect almost any organ in your body, literally from head to toe, heart is the most important organ that needs to be taken care of. In fact, heart disease is the cause of death in more than half of all deaths in diabetic people. So, it is vital to manage diabetes well to protect your heart.

There are several ways by which diabetes can affect your heart:

♦ There is increased production of cholesterol and triglycerides as a result of insulin resistance in diabetes, leading to atherosclerosis and narrowing of the heart arteries.

♦ Diabetes leads to increased tendency for blood clotting resulting in heart attacks

♦ Diabetes also causes impaired heart cell structure and function, leading to enlarged heart and reduced heart pumping function, a condition known as dilated cardiomyopathy. This condition may eventually leads to heart failure.

The exact cause of diabetes is not known. But simple lifestyle measures have been shown to be effective in preventing or delaying the onset of Type 2 diabetes. These include:

♦ Being physically active – doing at least 30 to 45 minutes of regular, moderate-intensity activity on most days is key.

♦ Eating a healthy diet – Make a diabetes meal plan with the help of a dietitian and stick to it. Choose vegetables and fruits, whole grains which have a low glycaemic index, low-fat and low-calorie diet. Avoid sugar and sweets.

♦ Achieving and maintaining a healthy body weight is crucial.

♦ Avoiding tobacco use as smoking increases the risk of diabetes and heart disease.

Early diagnosis of diabetes is important so that appropriate treatment can be instituted to prevent the further complications. This can be accomplished through relatively inexpensive testing of blood sugar. Once diagnosed, treatment should start immediately. Management of diabetes includes both the lifestyle changes and the pharmacological interventions.

Pharmacological interventions are:

♦ Oral antidiabetic medications – these are medicines to be taken by mouth and which reduce blood sugar levels in different ways. They are to be taken singly or in combination.

♦ Insulin – Different types of Insulin are available, depending upon the onset of action (rapid or slow), duration of action (short or long) and mode of delivery (needle and syringe, pen, pump, inhaler or injection port).

♦ Monitoring your blood glucose levels regularly plays an important role in managing your diabetes. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.

♦ The most common way to check your blood glucose level at home is with a blood glucose meter.

♦ Continuous glucose monitoring is another way to check your glucose levels. This involves using a tiny sensor that you insert under your skin. The sensor measures glucose levels throughout the day and night and helps to detect periods or episodes of too high or too low glucose levels, so that appropriate corrective actions can be taken.

Thus, though diabetes is a difficult disease to have, it is possible with a little bit of discipline to successfully manage your diabetes and lead a worry-free life.

Dr Suvarna is a Sr Interventional Cardiologist,
Asian Heart Institute, Bandra-Kurla Complex,
Mumbai