DIABETES - A CARDIOVASCULAR DISEASE

Abstract

The situation is alarming in developing countriesas glycaemia and diabetes arerising, driven both by population growth and ageing and by increasing age specific prevalences. The changing associations of metabolic risk factors withmacroeconomic variables indicate that there will be a global pandemic ofhyperglycemia and diabetes mellitus, together with high blood pressure in lowincomecountries, unless effective lifestyle and pharmacological interventions are implemented.Diabetes deprive women most of their inherent protection against developing CAD. CADs is the cause of death in more than 65% of persons with diabetes. Diabetes has been documented as an independent risk factor fordifferent forms of CAD. Patients with stress hyperglycemia, hyperinsulinemia and uncontrolled diabetes developed more mechanical and electrical complications claiming higher morbidity and mortality after a myocardial infarction.

Comprehensive risk assessment of diabetic patients must take into account major risk factors of CAD like cigarette smoking,elevated blood pressure, abnormal serum lipids and lipoproteins and hyperglycemia and predisposing risk factors like excessbody weight and abdominal obesity, physical inactivity and family history of CAD. Identification of risk factors shall include a thorough medical history, careful physical examination, and appropriate laboratory measurements. Risk factors like obesity,physical inactivity, and family history of premature CAD must be evaluated. Identification of predisposing risk factors mayprovide insight into the causation of major risk factors. Careful assessment of the status of the predisposing risk factor sets the stage for therapeutic intervention to control risk factors.

Diabetes may be labelled as a cardiovascular ailment and it has a dominant role in causation of various presentations of CAD. Itconspires with other risk factors and amplifies their role. Presence of diabetes determines worse outcome for patients afflictedwith acute coronary syndrome. Diabetes lowers the threshold for the treatment of other risk factors and reduces the ideal goalsfor blood pressure and cholesterol. Diabetes plays an important role in selection of interventional strategy for obstructivecoronary artery disease patient. The outcomes after intervention in diabetics are worse than non-diabetics and demand a moremeticulous control of hyperglycemia and associated risk factors.