Diabetes Effects on the Heart and Blood Vessels

Prolonged uncontrolled diabetes has serious effects on cardiovascular system including heart and blood vessels leading to serious diseases and complications. Type-2diabetes in particular has a close association with heart disease because it shares some of the common parameters of metabolic syndrome. 

The syndrome includes a set of traits and metabolic conditions such as accumulation of fat around the waist, elevated triglycerides level in blood, low level of HDL cholesterol (good cholesterol), hypertension, and elevated fasting blood sugar levels.

Among the damages caused by diabetes to the cardiovascular system, the most prominent effects are damage to inner lining of blood vessels, narrowing of coronary artery (or its blockage) due to plaque formation, poor circulation of blood to tissues and vital organs including brain, lungs and kidneys. 

Pathological changes in these organs lead to serious disease conditions. Some of the serious diseases which are linked to diabetes are: coronary artery disease, cerebral vascular disease, congestive heart failure, peripheral arterial disease, transient ischemic attacks and strokes.  

In diabetes, continued high levels of blood sugar over a long period of time are harmful to tissues and organs for their normal functioning. This also offers an environment to microorganisms to thrive and somewhat inhibit the body’s immune system and defense mechanism. 

High blood sugar causes  damage to blood vessels and thus affects circulation of nutrients and oxygen to deeper tissues and organs. Damage to coronary arteries leads to coronary artery disease which in turn can cause congestive heart failure. 

The damage caused to nerves leads to different types of neuropathies and foot ulcers. Diabetes along with hypertension also causes an increasing incidence of strokes.

Prevention primarily involves measures to regulate and control various parameters of metabolic syndrome such as increased weight, high triglycerides, high blood sugar, and hypertension. Basic preventive steps involve change in lifestyle by adopting healthy and nutritious diet and regular exercise. The other measures are regular monitoring of blood sugar and its control along with full compliance of all prescribed medications.

Diabetes needs to be treated for control of blood sugar. Treatment includes use of blood sugar lowering drugs or insulin to control blood sugar, anti-hypertensive drugs to lower blood pressure and drugs to control blood cholesterol. 

Any specific cardiovascular episode calls for immediate hospitalization and treatment under medical supervision. In case of stroke the patient needs earliest medical help within the first golden hour to dissolve the clot. In the long run the strategy is on treatment, management and healthy lifestyle.

Control of blood sugar is the foremost requirement for protection against harmful effect to the cardiovascular system as well as to safeguard against the worsening of any existing damage. Patient need to plan and strictly comply taking a healthy fiber rich nutritious diet low in trans fat and salt. Planning should include carbohydrate counting to control total calories intake. A high fiber, low trans and salt based diet is useful to reduce blood cholesterol and lower blood pressure. Those smoking must stop it immediately.

Controlled diet is very important in diabetes management. A dietician should prepare a diet chart for the patient which should be strictly followed. The diet should include high fiber (about 14 grams per 1000 calories). Total carbohydrate counting must be carried out to control total calories intake. Oat/oat meal, bran, wholegrain bread, cereals, vegetables and fruits need to be taken in plenty.

Dairy and bakery products and meats (except while and lean meat) must be avoided. Packaged food and fast food items rich in trans fats, snacks, fried foods, salad dressings made by using hydrogenated fats are unhealthy and harmful to patients.

Cardiovascular disease in a patient can exist independent of diabetes, but diabetes exaggerates heart disease in most cases. Diabetes and cardiovascular disease share common parameters of  metabolic syndrome and therefore one can lead to the other. 

In type-2 diabetes, insulin resistance reduces insulin's ability to lower blood sugar. In fat cells it reduces uptake of circulating lipids and increases hydrolysis of stored triglycerides thus increasing fatty acids in blood stream, a risk factor for heart disease. 

Diabetes' Effects on Kidneys

Kidneys are part of body’s excretory system and play a vital role in excreting waste substances formed as a result of metabolic activities. The kidneys role is in excretion of excess water, salts, acids, alkalis and in regulating blood pressure.

Kidneys have a system of small blood capillaries in them which filter out waste substances while retaining blood constituents like cells and proteins. In diabetes, continued high levels of sugar over a period of time damages fine blood capillaries resulting into kidney damage or nephropathies. 

These diseases cause leakage of proteins, blood cells and old other blood constituents into the urine. If hypertension is present it further complicates the disease. High sugar level and kidney damage invite infection causing nephritis, pyelonephritis, renal abscess and necrosis leading to kidney failure.

In diabetic patients, continued high blood sugar damages capillaries of the blood filtering system of the kidneys. This provides an ideal environment for infections to settle in and complicate the disease. 

Diabetics are at increased risks to infection by Escherichia coli and Proteus sp and acute pyelonephritis and also complications such as renal abscesses and papillary necrosis. Hypertension further aggravates the kidney disease.

A healthy lifestyle along with control of diabetes, hypertension and regular exercise are measures which can protect against kidney disease. Regular monitoring of urine for diabetics is necessary in order to detect, at the earliest stage, any signs of loss of sugar and protein in urine and take appropriate treatment to avoid permanent damage to kidneys. 

The diet should be taken in consultation with a dietitian.

Kidney damage due to diabetes manifests in different forms of neuropathies. Some common symptoms of renal disease are presence of albumen in urine, swelling on ankles and leg cramps, high level of creatinine in blood, nausea and vomiting, weakness skin irritation.

The disease may accompany infection in kidneys in the form of abscess and /or urinary tract infection. Therefore it is foremost to control diabetes and the infection by using suitable antibiotics. Diabetic patients having hypertension need to control it by using ACE inhibitors (captopril and enalapril) under medical supervision. 

Control of these factors will considerably improve renal function. If however damage to kidney (s) has occurred it may need dialysis and in more serious cases of kidney damage renal transplant may be carried out.

Patient is required to comply with prescribed diabetic diet and medical treatment in order to maintain blood sugar and blood pressure within the range and protect against infection. Personal hygiene of the patient along with the regular monitoring of kidney output and intestinal motility must be taken care of to avoid infection to the patient.

The diet need to fully conform to the requirements for sugar control in diabetic patients. The diet must be healthy nutritious but low in protein contents and salt. Low protein diet will avoid further damage to kidneys of having diabetes along with the kidney disease.

Diabetes belongs to the group of non-communicable diseases (NCDs) which share common causes for their occurrence. Hypertension, which falls in this group, causes complications in diabetic patients and aggravates kidney damage.

Lifestyle factors like sedentary life, unhealthy diet and overweight body are the main risk factors for all NCDs.

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Prevention of NCDs through Diet

Among the factors promoting NCDs are modifiable risk factors of use of tobacco products and alcohol, and inappropriate diets comprising high sugar intake, saturated fats, low fiber diets, and high salt intake. Concern for reduction of NCDs has aroused widespread concern for promoting different types of health diets to safeguard against those preventable diseases.

According to new rankings released by the U.S. News & World Report the best diet of 2012 is the Dietary Approaches to Stop Hypertension (DASH) diet. Depending upon one’s calorie needs the DASH diet prescribes the number of daily servings of grains, vegetables, dairy and other food types.

DASH diet aim at preventing and lowering high blood pressure. The diet also has good nutritional value. In a competition, it has received the recognition of the best diet second time. The second place has been won by the Therapeutic Lifestyle Changes (TLC) diet, which aims to lower cholesterol, and the third place to the Mayo Clinic diet, which focuses on weight loss.

TLC diet is an example of a wonderful 'medical' type of diet that has gone mainstream, according to one nutritionist. Its low sodium requirement means boost to heart health. It is also reported to be easy to follow as the success of a good diet is its ability of ease it offers to the user.

The U.S. News & World Report judged various diets through a completion; a panel of 22 experts in diet, nutrition, obesity, food psychology, diabetes and heart disease ranked diets. The experts rated the 25 diets in seven categories: depending upon the ease required to follow the diet, their ability to produce short-term and long-term weight loss, nutritional completeness, safety and potential for preventing and managing diabetes and heart disease.

Diets for weight loss                                                 

According to rankings, the top three diets for weight loss are the Weight Watchers diet, the Biggest Loser diet and the Jenny Craig diet. Dieters had the best result with Weight Watchers for both short and long term weight loss, and it ranked highly in terms of ease to follow it. The Weight Watchers plan is a diet that people most often return to. The experts rated the Weight Watchers diet as a 3.7 out of 5 in the category of easy to follow, whereas the Biggest Loser diet scored a 2.9 in this category, according to the rankings.

The Jenny Craig diet scored a 3.6, but fared less well than Weight Watchers in terms of its ability to produce weight loss. Weight Watchers won the category of best commercial diet plan, as against the Jenny Craig diet, which relied heavily on packaged meals and came with a high cost, according to the rankings.

However, when Consumer Reports released its ratings of commercial diet plans in May, Jenny Craig ranked as the winner. Those raters acknowledged criticisms that the diet is hard to follow, but cited a two-year study of 332 people showing that 92 percent of participants stuck with the diet. That study was published in the Journal of the American Medical Association in 2010.

Diets for healthy eating

The DASH and TLC diets topped the category of best diets for healthy eating, which emphasized nutritional completeness and safety. The Mediterranean diet ranked third. The data, according to one expert, show that the DASH diet offers the best overall nutrition, “ it has one of the highest levels of B-12 and potassium”. Whereas the Weight Watchers plan is low in those nutrients, and recommended that its followers take a multivitamin.

The DASH diet prescribes a number of servings of grains, vegetables, dairy and other food types that a person should eat daily, based on one’s calorie needs. It suggests high amounts of fiber, potassium and magnesium, and keeps sweets to a minimum. The diet caps salt intake to the recommended daily values—1,500 milligrams for people who are age 51 or older, African-American, or have hypertension, diabetes or chronic kidney disease; 2,300 milligrams for everyone else.

The DASH diet also won in the category of best diabetes diets, while the Ornish diet, which groups foods from most healthful (fresh fruits and vegetables, vegetarian protein sources) to least healthful (cakes, cookies, bacon, sausage), ranked first in best heart-healthy diets.which focuses on low fat intake and emphasizes exercise and stress management, won for best heart-healthy diet. One panel has decided the best diet of 2012 is the DASH diet, which emphasizes consuming lean protein, fruits and vegetables.