We are not just referring to numbers and statistics, but to the fact that diabetes is an important risk factor that affects several organs, namely the heart. And if the probability of developing cardiovascular disease is twice as high compared to the non-diabetic population, it is also known that cardiovascular disease (CVD) is the main cause of death for people with diabetes.
Both pathologies have the common denominator of being silent in the initial stages, which brings additional challenges to an adequate diagnosis. Often, a patient realizes that he has diabetes during a hospital stay due to stroke (stroke) or acute myocardial infarction. That is, at a stage when diabetes will have already caused damage to several organs.
The Directorate-General for Health (DGS) defines diabetes as a chronic disease increasingly common in our society, whose prevalence increases greatly with age, affecting both sexes. Characterized by the increase in blood sugar (glucose) levels – hyperglycemia -, it is estimated that it affects one million Portuguese people and that around two million more are at risk of developing diabetes.
Diabetes mellitus type 2, which corresponds to more than 90% of cases, is also known as “non-insulin-dependent” and occurs mainly in individuals who have inherited the predisposition to develop the disease and who, due to environmental factors, among which the habits of such as hypercaloric nutrition, physical inactivity and, sometimes, stress, suffer from diabetes in adults.
There is a concern among the medical community with the adequate control of diabetes, so it is imperative to involve health professionals and civil society in prevention, diagnosis and treatment. Working together between medical societies, healthcare professionals and patients can make a difference when it comes to early diagnosis and timely treatment of diabetes and cardiovascular disease.
How to control diabetes?
Asymptomatic, diabetes silently worsens and, at the same time, increases the danger to heart health. It is in the hands of each of us to promote our health, seek to adopt healthy lifestyles and fight obesity, one of the most relevant risk factors for the development of type 2 diabetes.
When a diagnosis already exists, it is not indifferent how it is controlled. “There are new drugs that, in addition to controlling blood glucose, reduce cardiovascular risk. A few years ago, the focus was on looking for drugs to control blood glucose, in order to avoid hyper and hypoglycemia. But, currently, we have drugs that, in addition to treating diabetes, offer protection to the heart and the circulatory system, reducing the risk of cardiovascular events ”, argues Ricardo Fontes Carvalho, cardiologist at Centro Hospitalar VN Gaia-Espinho. In the last three to four years, new pharmacological classes have emerged that allow the treatment of diabetes and, at the same time, protect the heart and even the kidneys, says the professor at the Faculty of Medicine, University of Porto. “Thanks to these new treatments, we have managed to reduce the impact of diabetes on the risk of cardiovascular disease. It no longer matters – just – to lower blood sugar, but the way blood sugar is lowered and what complementary benefits can diabetes therapy bring to the patient at other levels ”, he argues.
Therapeutic novelties have thus altered the paradigm of understanding the disease and bring new hope in reducing the impact of diabetes on the risk of cardiovascular disease. “It is important for the patient to know that there is this close relationship between diabetes and cardiovascular diseases and to speak to their doctor, as there are many people with diabetes who do not know they have cardiovascular disease and also the opposite, patients with cardiovascular disease who they don’t know they have diabetes. Having an early diagnosis and starting treatment with benefits for both diseases is essential to keep them properly controlled and to avoid risky cardiovascular events, such as stroke and stroke, “says Daniel Ferreira, cardiologist at Hospital Luz Lisboa and director Hospital da Luz Centro Clínico Digital.
It is essential to optimize the management of these two chronic diseases and this is achieved through an adequate compliance (adherence to therapy) even when patients feel good or have good results in blood tests, but also through the monitoring of a multidisciplinary team and the articulated work between cardiology, endocrinology and diabetes.
The results of the world’s largest study on cardiovascular disease and type 2 diabetes were presented this month at the annual conference of the European Association for the Study of Diabetes (acronym in English, EASD). The CAPTURE study, developed by Novo Nordisk, analyzed the prevalence of cardiovascular disease, cardiovascular risk and its management in the population with type 2 diabetes. In this study, it was demonstrated that 1 in 3 people with type 2 diabetes has established cardiovascular disease, of which 9 out of 10 have atherosclerotic cardiovascular disease. However, only 2 out of 10 people with type 2 diabetes and atherosclerotic cardiovascular disease are treated with a hypoglycemic treatment with proven cardiovascular benefits.
Don’t postpone your health
The Covid-19 pandemic has changed the way we live and is having an impact on the demand for health services. Thus, some reports are known of the impact that the postponement of consultations has caused in the screening of some diseases, in the promotion of health and in the management of chronic diseases. Fearful – albeit legitimate – of being infected with Covid-19, some people chose not to carry out their routine consultations or seek specialized help in a timely manner. And if it is true that many medical consultations and procedures were postponed during the period of confinement, it is also certain that everything is gradually returning to a certain normality and that it is safe to visit health centers, clinics and hospitals that respect the standards recommended by the DGS.
The fear of visiting the health center, for example, keeps diabetic patients from having their diabetes under control, which is also harmful with regard to Covid-19 because it puts patients at greater risk of developing serious complications in the if they are infected with the new coronavirus.
On this World Heart Day, we leave the alert: do not forget yourself or your health.