Diabetics may not feel classic heart attack symptoms

People with diabetes are three times more likely to die from heart disease than the general population

New Delhi: People with diabetes may not always feel classic symptoms like acute chest pain when they have a heart attack, according to a small study that offers a potential explanation for why these episodes are more deadly for diabetics.

Researchers examined data from detailed interviews with 39 adults in the UK who had been diagnosed with diabetes and had also experienced a heart attack. Most of the participants reported feeling some chest pain, but they often said it didn’t feel like they expected or that they didn’t think it was really a heart attack.

“Long term diabetes damages your heart in many ways (increased blocking of the heart’s blood vessels), but it also damages your nerves,” said study co-author Dr. Melvyn Jones of University College London.

 “So a bit like a diabetic might not feel the stubbing of their toe, they also feel less pain from damaged heart muscle when the blood supply gets cut off, so they don’t get the classical crushing chest pain of a heart attack,” Jones said by email.

People with diabetes are three times more likely to die from heart disease than the general population and possibly six times more likely to have a heart attack, Jones added.

All patients in the study received care at one of three hospitals in London, and they ranged in age from 40 to 90. Most were male, and roughly half were white.

The majority had what’s known as type 2 diabetes, which is tied to aging and obesity and happens when the body can’t properly use insulin to convert blood sugar into energy. Four of them had type 1 diabetes, a lifelong condition that develops when the pancreas produces little or no insulin, a hormone needed to allow blood sugar to enter cells.

Many of the participants described heart attack symptoms such as chest pain and discomfort.

However, many felt like their pain wasn’t severe enough to be a heart attack or didn’t consider the discomfort they felt in their chest as similar to what they would expect with a heart attack.

This may have contributed to delays in seeking care, which are in turn associated with lower survival odds and a higher risk of complications and disability for people who do live through the event, researchers note in the journal BMJ Open.

The study was small, and it wasn’t a controlled experiment designed to prove whether or how diabetes might lead people to experience different heart attack symptoms.

Still, it confirms a longstanding belief that people with diabetes may be prone to atypical heart attack symptoms, said Dr. Deepak Bhatt, executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital Heart and Vascular Center and a researcher at Harvard Medical School in Boston.

“Atypical means instead of the more classic chest pain or chest pressure, patients experience symptoms such as extreme fatigue or breathlessness, for example,” Bhatt, who wasn’t involved in the study, said by email.

“The biology of the heart attack is the same,” Bhatt added. “But the thought is that patients with advanced diabetes may have a degree of nerve damage (neuropathy) and therefore may be less likely to experience the more common chest pain or chest pressure from a heart attack.”

Patients with diabetes should understand that they’re more likely to have a heart attack than other people, said Dr. John Wilkins, a researcher at Northwestern University Feinberg School of Medicine in Chicago who wasn’t involved in the study.

“They should have regular follow-up with their physicians, keep their blood sugars well controlled, lead a heart-healthy lifestyle, avoid the development of cardiovascular risk factors like high blood pressure and high cholesterol, and if they have risk factors they should make sure they are appropriately managed,” Wilkins said by email.

“They should also be familiar with the symptoms that suggest that they might be having a heart attack or an impending heart attack and know how to respond if those symptoms develop,” Wilkins advised.

source :http://zeenews.india.com/health/diabetics-may-not-feel-classic-heart-attack-symptoms-2051609 

Wife’s Obesity Could Increase Risk of Diabetes in Men :

According to a latest study, a wifes obese condition can not only up her diabetes risk but her husbands too.

Obesity is a disorder involving excessive body fat that increases the risk of various other health problems. For the longest time, experts have studied the effect of obesity on an individual in detail, but according to a latest study, a wife’s obese condition can not only up her diabetes risk but her husband’s too. The study revealed that obesity can substantially increase her risk of developing Type 2 diabetes, especially in middle age -- but women with an obese husband have no additional risk.

The study revealed that for every 5 kg/m2 higher BMI in a wife, the husband's Type 2 diabetes risk was 21 per cent higher when accounting for the man's own BMI.
Adam Hulman from Aarhus University in Denmark said, "Having an obese wife increases a man's risk of diabetes over and above the effect of his own obesity level, while among women, having an obese husband gives no additional diabetes risk beyond that of her own obesity level.”

"Our results indicate that on finding obesity in a person, screening of their spouse for diabetes may be justified," Hulman added.

The research, also suggests that people over 55 with a spouse with Type 2 diabetes tend to be more obese than their peers without a diabetic partner.

The study presented at the 2017 European Association for the Study of Diabetes (EASD) Annual Meeting in Lisbo further explained that obesity or Type 2 diabetes in one partner could lead to Type 2 diabetes in the other due to the many risk behaviours which often leads to diabetes shared by couples, such as unhealthy eating habits and inadequate physical activity.

"Recognising shared risk between spouses may improve diabetes detection and motivate couples to increase collaborative efforts to eat more healthily and boost their activity levels," Hulman said.



From heart diseases to diabetes, being heavily overweight can prove to be a harbinger of many health risks. Here are some effective ways  which can come in handy to tackle obesity:

1.Include more whole grains in your meal: .Whole grain provide energy to sustain and grow and are also a major source of all essential nutrients. Ditch processed cereals and load up on whole grains like Bajra, Ragi, Maize and Jowar, and use them often. Try brown rice instead of white rice .

2.Keep the trans fats away: Industrial trans fats are often present in fast foods, street snacks, fried foods, cookies, margarine and spreads. Read the labels; if there is no label, find a better substitute.

3.Do not skip meals: Eat three balanced meals. Take a standard dinner plate, fill ½ with vegetables, 1/3rd with cereal, 1/3rd with protein, and add 150 ml of milk/dahi/dessert.

4.Limit your intake of sugar: Sugar is a source of many excess calories which practically does nothing for your body, and goes on storing as fat. While it is important to stay away from refined sugars, do note that a lot of foods have natural sugar hidden in them too. It  is advisable to keep the  intake less than 10% of your total calories. For a normal weight woman who needs 1900Kcal/day this is about 10 -11 teaspoons of sugar.

5.Eat protein with every meal: Proteins take longer to digest which means that they keep you full for longer and also help in reducing the total body fat. Having protein-rich foods like amaranth, sprouts, peas, and eggs helps in accelerating weight.

SOURCE : https://www.ndtv.com/food/wife-s-obesity-could-increase-risk-of-diabetes-in-men-5-handy-tips-to-keep-obesity-in-check-1749610

TAKE CARE OF YOUR FEET MORE THAN YOUR FACE

We all know that India is fast becoming the diabetes capital of the world. There are about 69.2 million diabetes patients in India which is expected to reach 123.5 million by the year 2040.

Development of foot ulceration is a common problem in patients with longstanding diabetes. Life time risk of developing foot ulcer may be as high as 25%. Foot ulceration is one of the leading causes of hospital admission in patients with diabetes mellitus. 60% of admissions in diabetes patients are for foot problems. 1% of diabetes patients may lose a portion of their limb in lifetime. In India prevalence of foot ulcer in people with diabetes is 3%.

The reason why diabetes patients are more prone to foot problems are vasculopathy i.e. involvement of blood vessels, neuropathy i.e. involvement of nerves, development of infection and many other co-existing problems such as old age, immunosuppressive states, hypoproteinemia and poor blood sugar control. The blood vessels in diabetic patients are affected by atherosclerosis i.e. deposition of fat inside blood vessels causing lead pipe arteries with resultant loss of its elastic property. Further calcification of blood vessels lead to poor distal blood flow.

Neuropathy, the involvement of nerves can occur because of autonomic, sensory and motor neuropathy. Autonomic neuropathy is the loss of autonomic control resulting in inhibition of thermoregulatory function and sweating. It results in dry, scaly and stiff skin that is prone to cracking and allows the entry of bacteria. Sensory neuropathy is the loss of protective sensation. It starts distally and migrates proximally in stocking distribution. Motor neuropathy results in foot deformities like hammer toes, claw toes, hallux valgus and flat feet.

Presence of high plantar pressure due to obesity, deformities in the foot, limited joint mobility further leads to development of foot ulcer. Ill-fitting footwear may further aggravate the situation. Majority of ulcer occur below head of 1 st metatarsophalangeal joint. Diabetic foot are usually classified as neuropathic foot or neuroischaemic foot meaning either only nerve is involved or both nerve and blood vessels are involved. There are various type of therapy available to treat diabetic foot ulcer ranging from simple surgical debridement to hyperbaric O 2 therapy, vacuum therapy, injections of G-CSF/Zolendronate.

Prevention of the developing ulcer is better than cure
*Feet should be washed daily using warm water and soap. After washing, feet should be dried with a dry towel especially between the toes followed by application of moisturizing lotion.
*Avoid wearing socks with rough seams as seamless diabetic socks are available.
*Toe nails should be trimmed regularly. Ingrown toe nails should not be removed at home.
*Avoid cutting nails if they are thick or hard and visit a local chiropodist.
*Corns and calluses should not be trimmed with scissors, knives or razor blades.
*Foot care should be a routine in the life of a diabetic along with good blood sugar control.

SOURCE : http://timesofindia.indiatimes.com/life-style/health-fitness/every-heart-counts/take-care-of-your-feet-more-than-your-face/articleshow/60837360.cms