By Dr C.M. Batra
According to the International Diabetes Federation’s ‘Diabetes and Cardiovascular Disease report, in 2015, approximately five million were estimated to have died from diabetes, the majority of these as a result of cardiovascular complications. The report adds that populous countries have the largest absolute number of people dying from CVD, and include China, India and the Russian Federation.
While India is ranked at Number 67 in terms of age-standardised CVD mortality rate (306 deaths per 100,000 people per year), it has the second-largest number of people dying from CVD (over two million deaths per year).
One of the significant outcomes of cardiovascular disease is poor circulation in the legs, resulting in heightened risk of foot ulcers and amputations leading to disability. When people with diabetes develop CVD, their probability of survival is lower than those CVD patients without diabetes.
Diabetes can lead to cardiovascular damage in multiple ways. When a person has uncontrolled diabetes, the blood sugar levels are usually higher. And too much sugar in the blood damages blood vessels.
Although diabetes is regarded as the strongest risk factor for CVD, it is not just high blood glucose levels, but a variety of mechanisms that lead to CVD. The blood vessels in people with diabetes are more susceptible to well-established risk factors such as smoking, high cholesterol, high blood pressure and obesity. More than 80 per cent of people with type 2 diabetes are overweight. About 70 per cent of people with diabetes have high blood pressure and 67 per cent of adults with type 2 diabetes have one or more lipid (cholesterol) abnormalities.
Evidence now suggests that to prevent diabetes-related complications, one needs to look beyond glucose control and focus on other conditions like reducing weight, controlling high blood pressure and abnormal lipid profile.
In short, a person with diabetes needs to take care of the A, B and C of diabetes:
A stands for HbA1C (the test gives average blood glucose for last three months). It should be ideally less than seven per cent and is recommended at least three times a year.
B stands for blood pressure. The goal of blood pressure control is to reduce it to
C stands for cholesterol. The cholesterol that needs to be checked is the HDL, LDL and the triglycerides. The three should be within the specified limits. The optimal target is less than 100 milligrams per deciliter (mg/dL) for LDL cholesterol. For HDL cholesterol, the recommended level is more than 50 mg/dL for women and more than 40 mg/dL for men. Lipid profile is recommended at least once in a year.
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If blood glucose, blood pressure, and cholesterol levels are not on target, then a person with diabetes needs to reach out to their doctor. Appropriate medicine and few changes in diet and activity can help him/her reach these goals. Here are four things you can do to lower your risk:
In conclusion, be aware, be active and be prompt to save yourself from diabetes and its complications – it’s time to act.
(Dr. C.M. Batra is an endocrinologist ar Indraprastha Apollo Hospitals, New Delhi. The views expressed are personal. He can be contacted at chandarbatra@yahoo.com )
–IANS