Comfortably Numb! Silent Heart Attacks in People with Type 2 Diabetes

Did you know? About 50% of heart attacks are mistaken for acidity or other less serious problems


1. Diabetes & heart diseases are the biggest killers in India.
2. People with diabetes are more prone to heart diseases.
3. People who have diabetes have high blood sugar levels, high triglycerides, and low HDL levels, which makes them prone to atherosclerosis.
4. People with diabetes are prone to silent heart attacks.
5. Silent heart attacks are heart attacks that are equally lethal.
6. Silent heart attacks come with less intense symptoms,but have same amount of heart muscle damage.
7. To prevent heart and cardiovascular diseases, diabetics have to reduce their triglyceride and low-density cholesterol levels, and increase their high-density cholesterol levels.
8. Maintain healthy diet.
9. Get regular exercise (more than 150 minutes per week).
10. Maintain blood pressure as advised by doctor.
11. Restrict sodium intake.
12. Manage stress.
13. Maintain blood glucose levels.
14. Get periodical medical examinations.
15. Stick to medical advice.

Special Heart healthy tips for diabetics

The World Heart Day is on September 29th and it is time to bare our heart! Though as a nation India is young at heart, we are faced with a huge burden of heart and cardiovascular diseases. It is estimated that India has witnessed an increase of around 59% in mortality from cardiovascular diseases and there is bad news for people with diabetes if they do not take precautionary measures. The mantra for people with diabetes is strict diabetes control!

Heart Diseases and India

There seems to be an affinity between heart diseases and India. And, it might be a shocker to many when we reveal the fact that more and more young Indians are falling prey to heart diseases in their prime. It is a fact that 50% of all heart attacks and cardiovascular diseases are occurring in people younger than 50 years of age!

Some of the reasons that leading cardiologists state are:

• Sedentary lifestyles without exercise.
• Poor dietary choices with junk food.
• Obesity.
• Smoking.
• Alcohol.
• Diabetes.

Unknown Heart Facts:As against popular belief, sneezing does not stop your heart. In fact, in a lifetime, the heart beats for more than 2.5 billion times!

Apparently, almost all these risk factors are avoidable! Yet, one of the most significant factors for cardiovascular diseases is diabetes. In fact, diabetes is guilty of causing another life-threatening but oft missed condition, the silent heart attack!

Eleven tips to keep heart disease at bay

1. Quit Smoking.
2. Maintain Blood Pressure.
3. Maintain Cholesterol levels.
4. Get more than 150 minutes of physical activity every week with some aerobic activity.
5. Manage Stress.
6. Manage Weight. Maintain healthy weight.
7. Control your blood sugar levels.
8. If you snore, check yourself for sleep apnea.
9. Get a healthy diet with plenty of fiber, vegetables, whole grains, fruits, and fats with omega-3 fatty acids.
10. Assess yourself for peripheral artery disease (PAD) periodically.
11. Know about the warning signs of heart attack and get immediate medical help.

Diabetes, the Stealthy Killer

Diabetes Mellitus, we all know that this condition causes the glucose levels to rise in the blood and makes us sick. Well, that is the level of awareness most people have. But, some of you might be aware that there are certain complications of diabetes like diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy. You might also be aware that diabetes can affect your kidneys due to excess blood glucose levels and damage your kidneys, but did you ever wonder that diabetes can cause heart diseases?

Yes, you heard that right! Diabetes is one of the leading risk factors for heart diseases and it causes a heart attack which you might not even be aware of!

Unknown Heart Facts: Your feet might give you signals of a future heart attack! If your shoe size steps up a notch, your body might be retaining water. This is a cardiovascular redflag!

The Metabolic Dual Effect – Cholesterol and Blood Glucose

Sometimes trouble comes in pairs
This is very true in the case of people with diabetes. As a variable metabolic disorder, diabetes mellitus does more to the body apart from increasing blood glucose levels. Glucose and lipid metabolism are closely linked to each other and diabetes leads to a condition called diabetic dyslipidemia. This condition is characterized by a marked increase in the levels of triglycerides, which is a high risk for heart disease.

The heart of the matter is that when a person develops insulin resistance, the method in which cholesterol is synthesized changes. This is in fact irrespective of the factwhether the person is overweight or not!

There is a strange relationship between fasting blood sugar levels, postprandial levels, triglycerides, and high-density cholesterol in people with diabetes. The general pattern is that all these levels are elevated except for high-density cholesterol levels, which tends to be very low.

This happens as a result of a barrage of free fatty acids that are released from the peripheral tissues. When these free fatty acids flood the liver, there is an increased production of triglyceride-rich lipoprotein, which results in hypertriglyceridemia.

This is not the end! Hypertriglyceridemia in turn leads to many chain reactions leading tolow levels high-density cholesterol. Increased triglycerides and low-density cholesterols lead to atherosclerosis and numerous cardiovascular diseases like peripheral artery diseases and can lead to heart attacks.

Insulin resistance and its mechanismsnot only increase the production of very low-density lipoproteins (VLDL) from the liver, it also assists the production and storage of triglycerides in the adipocytes (fat cells present in the adipose tissue).

Apart from the lipids that flow into the body from the liver, the stomach also contributes its might to the buildup of cholesterol in people with diabetes leading to the increased risk of heart diseases.

Diabetes and Atherosclerosis :

Atherosclerosis: It is a disease in which oxygen carrying arteries have a buildup of plaque. Plaque consists of cholesterol, fat and calcium. Atherosclerosis leads to heart attack, and stroke.

We all know that hypertension, obesity, and smoking as leading causes for heart diseases, but we do not know that diabetes is a cause for heart diseases. We have just seen the link between high triglyceride levels and diabetes and now let us see the connection between diabetes and atherosclerosis.

It is with a heavy heart that one has to say that the relation between high blood sugar levels, high triglyceride levels, and low HDL levels has a big say in the incidence of heart diseases. And, not only is high triglyceride level a risk factor, low HDL level is also high risk factor for the development of heart diseases.

This unholy triad of high blood sugar levels, high triglyceride levels, and low HDL levels are responsible for a host of conditions like pancreatitis, and atherosclerosis. The take home point for people with diabetes is to maintain a strict diabetes control, one that focuses on fasting sugar levels, postprandial levels, and HbA1c levels.
Of note, it is very important to maintain the postprandial triglyceride and blood sugar levels as abnormal lipid metabolism post meals is known to cause increased production of very low-density lipoproteins (VLDL) from the liver.
Unknown Heart Facts:The pressure a heart generates is so strong that it is enough to squirt blood thirty feet across.

The Silent Heart Attack

We are all aware of the classic symptoms of heart attack – The perspiration, the squeezing pain on the left side, and pressure sensation. Now, brace yourself to have your heart in your mouth! For people with diabetes, heart attack occurs and you would not even know about it!

Known as silent myocardial infarctions, these occur with symptoms less intense than regular heart attacks and can be fatal! These can happen when one is feeling fatigue, physical discomfort, or throat pain and is often confused as gastric problem or reflux disease.

This might alarm you as it is normal to have discomfort or heartburn due to indigestion, but it is vital to note the difference for a person with diabetes. As such, a person with diabetes suffers a lot of diabetes complications involving the blood vessels and added to it the unholy triad mentioned above increases the risk of a silent heart attack in people with diabetes further.

Added to all these risk factors, nerve damage that occurs in people with diabetes can aggravate the situation. Known as diabetic neuropathy, this condition can diminish the sensation of pain felt during a heart attack making a person feel like he/she is having a bout of indigestion rather than a heart attack.

Who is at risk of a silent heart attack?

• Smokers.
• People with high cholesterol.
• People with high blood pressure.
• Diabetics.
• People with overweight.
• Age.
• Physically Inactive.

Here are a few symptoms you need to watch out for in case of a silent heart attack:

• Discomfort in chest (center) for several minutes.
• Discomfort in the upper body (arms, back, neck, jaw, stomach).
• Shortness of breath during discomfort.
• Sweating.
• Lightheadedness.

These silent heart attacks, if not fatal, damage the heart muscles. In fact, they can be so mild that they can be brushed off as indigestion or heartburn. So, if you are in doubt, get an ECG or ask your doctor for a blood test (troponin T, a molecular footprint that is released after heart muscle damage).
If you have diabetes, there is no need to be heartbroken with these risk factors. There are ways you can protect your heart and it starts with good blood sugar control. Here are other tips you can follow to give you a heart of gold!

• Reduce abdominal fat.
• Maintain your blood pressure.
• Maintain your blood glucose levels.
• Maintain fasting, postprandial, and HbA1cat target levels.
• Reduce stress.
• Consume antioxidant-rich diet.
• Eat foods with soluble fiber.
• Eat fish instead of poultry and red meat.
• Make sure you laugh daily.
• Do yoga.
• Reduce intake of salt.
• Stay physically active.
• Eat dark chocolate (only occasionally).
• Eat nuts for snacks.
• Reduce caffeine-containing products and opt for green tea.
• Improve your sexual life.