Diabetes And Heart

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  • Diabetes And Heart

    1. 1. Diabetes & Heart
    2. 2. Conventional Cardiac risk factors… superimposed on the diabetic state … Hypertension Microalbuminuria Inactivity South Asian origin Dyslipidaemia Obesity … further accentuate atherosclerosis in the diabetic state…accounting for the excess Cardiac risk
    3. 3. Why does diabetes predispose to atherosclerosis? <ul><li>Metabolic abnormalities…in diabetes </li></ul>High blood sugar High lipid Insulin resistance Alter the normal function of 3 different cell lines ARTERY … and their destruction leads to atherosclerosis Endothelial cell Platelet Smooth muscle cell
    4. 5. Heart Attack Which patient is at greater risk of future attack? An attack survivor A typical Type 2 diabetic
    5. 6. Risk Factors and C.H.D. Adapted from : Stamler; Diabetes Care,12,573 (1989) Cholesterol. Smoking. Hypertension .
    6. 7. Heart Attack Equal risk An attack survivor A typical Type 2 diabetic Without heart problem
    7. 8. Atherosclerosis in T 2 DM <ul><li>~80% of all people with Diabetes dying </li></ul><ul><ul><ul><li>75% from coronary atherosclerosis </li></ul></ul></ul><ul><ul><ul><li>25% from cerebral or peripheral vascular disease </li></ul></ul></ul><ul><li>>75% of all hospitalizations are for diabetic complications . </li></ul>National Diabetes Data Group. Diabetes in America. 2nd ed. NIH;1995.
    8. 9. Death after MI Herlitz J et al, Acta Med Scand 1988
    9. 10. Managing Diabetes : 4 Cardinal Rules for the Patient <ul><li>1. Follow a healthy meal plan 2. Regular exercise </li></ul>3. Take your medication 4. Test your blood glucose regularly

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