Cardiovascular complications can easily take the life of diabetics

According to Associate Professor, Dr. Nguyen Thi Bich Dao, Deputy Director of Endocrinology – Metabolism and Nutrition, Department of Cardiovascular Metabolism – Tam Duc Heart Hospital, diabetes, also known as diabetes, is an endocrine metabolic disease characterized by chronic hyperglycemia (blood sugar), accompanied by metabolic disorders of protein, lipid and minerals… This is a chronic progressive disease.

Elevated blood glucose, not well controlled according to individualized goals, will affect blood vessels and non-blood vessels, leading to disorders and impaired function of many organs, especially the heart.

The relative risk of cardiovascular death in adults with diabetes is 1-3 times higher in men and 2-5 times higher in women than in people without diabetes. Accordingly, cardiovascular disease is the leading cause of death in people with diabetes. The high risk of cardiovascular disease in people with diabetes is also contributed by other factors such as genetics, comorbidities such as hypertension, dyslipidemia, etc.

Studies show that there is a close relationship between diabetes and cardiovascular disease. The most important mechanism is that high blood glucose causes early damage to endothelial cells, causing vascular endothelial dysfunction.

When the endothelial function is disturbed, it will make cholesterol molecules easily penetrate the endothelium, combined with increased adhesion and penetration of white blood cells into the endothelium. From there, atherosclerotic plaques will form, or atherosclerotic plaques that have formed will progress very quickly, leading to gradual narrowing of the lumen of the blood vessels, causing clinical manifestations of chronic ischemia in organs and tissues.

In addition, when the vascular endothelium is damaged, it will create favorable conditions for vasoconstriction combined with platelet adhesion, forming a blood clot in the lumen of the blood vessel, causing chronic or acute vascular occlusion.

According to Associate Professor Dao, the manifestations of cardiovascular complications in diabetic patients are very diverse. Including coronary artery disease, cerebrovascular disease, peripheral vascular disease, diabetic cardiomyopathy, heart failure…

When there is damage to the coronary arteries, ischemia due to stenosis will lead to angina, myocardial infarction, sudden death. Damage to the cerebral blood vessels will lead to transient ischemic attack, stroke. Damage to the arteries of the limbs will lead to manifestations of arterial occlusion of the limbs (intermittent claudication, necrosis of the extremities…).

Many patients only know they have diabetes when they have complications in the heart, eyes, brain, kidneys, or nerves. And vice versa, many people have diabetes for a long time, but because they do not go for examination and treatment at medical facilities, the above complications are not detected.

The strategy to prevent disease is better than cure will include levels for groups of members: healthy people who do not have the disease, healthy people who do not have the disease but are in the high-risk group, people whose disease is detected early through screening, People who have had diabetes for a long time, people with complications…

For people with diabetes, comprehensive management is the general principle. Individualized, targeted blood glucose management is key, but maintaining stable long-term results in practice is difficult.

Good control of blood sugar as soon as possible, protecting target organs such as the heart and kidneys, reducing MACE, reducing cardiovascular mortality and overall mortality are current treatment requirements of the above diabetes associations. world and Vietnam. Therefore, the new solution in the guidelines is to control blood sugar – control weight while protecting the heart and kidneys. For the elderly, choosing solutions and drugs when approaching treatment must be individualized and according to the criteria of effectiveness – safety – simplicity – reasonable cost.

At the same time, to detect complications early, patients need to have regular check-ups and perform necessary tests. In addition, patients also need to understand the symptoms, especially the early manifestations of the disease, to receive timely treatment.