‘Understanding co-relation between diabetes and heart disease crucial’

November 14 of each year marks the observation of World Diabetes Day, and this year’s theme is The Nurse and Diabetes.

The campaign aims to raise awareness around the crucial role that nurses play in supporting people living with diabetes, according to a press release issued on Saturday.

Prof Nayyer Ul Islam, eminent physician, diabetologist, associate dean of Clinical Medicine and the head of the Medical Department at the Karachi Institute of Medical Sciences, CMH, Malir Cantonment, Karachi, said at a webinar organised by M. Hashim Memorial Trust on World diabetes day that diabetes is the fourth leading cause of deaths in the world.

Diabetes was increasing at a rate of over seven per cent in South Asian countries annually and the number would double by 2030, he added.

As many as 150,000 to 200,000 people lose their lower limbs every year in Pakistan due to complications of diabetes and 70 per cent of them die within five years of amputation.

“Don’t forget that a significant proportion of diabetics also have hypertension, so there might be a complex interplay of factors involved,” Dr Nayyer Ul Islam said.

In Covid-19 epidemic in Pakistan, general measures like social distancing, regular handwashing and wearing a mask and gloves should be adopted, and diabetics and other patients with chronic diseases should also quit smoking, he advised.

Prof Faisal Ahmed, consultant interventional cardiologist and HoD at the LNH & Tabba Heart Institute, spoke about the importance of the awareness of heart disease in diabetics.

He added that while Type 2 diabetes is known to cause a variety of health complications such as numbing of the peripheral and optic nerves and kidney disease, few know that diabetes damages the coronary artery, causes higher incidence of accumulation of bad cholesterol which gets deposited in the arteries narrowing them and making diabetics more at risk for cardiovascular diseases.

He pointed out that people failed to see the co-relation between diabetes and heart disease, and awareness could help them take preventive steps to ward off heart disease as over 52 per cent of patients with Type 2 diabetes died of cardiovascular causes.

Risk factors for diabetes include being overweight and physically inactive or having a family history of the disease.

If left untreated, diabetes can result in serious complications, including CHD, PAD, kidney failure, stroke, lower limb amputations, and blindness.

Prof Mudassir Iqbal Dar, consultant cardio-thoracic surgeon and head of the Cardiac Surgery Department at The Gambat Institute of Medical Sciences, gave a cardiac surgeon’s perspective on coronary heart disease in diabetics and shared his experience in dealing with cardiac patients.

According to the expert, the prevalence of diabetes among patients undergoing cardiac surgery is around 60 per cent, diabetic patients usually have severe coronary vessels disease and have more chances of post-operative complications.

Renowned ophthalmologist and philanthropist Prof Sharif Hashmani said diabetic retinopathy is the leading cause of preventable blindness among Pakistanis and it affects over one in four of those living with diabetes.

“In simple terms, diabetic retinopathy is caused by changes to the blood vessels of the retina. Poor glucose control and hypoxia cause new weak blood vessels to grow and leak fluid into the back of the eye, abnormal blood vessels also grow on the surface of the retina, which can bleed and block vision,” Prof Hashmani added.

He said 98 per cent of diabetic vision loss could be prevented with early detection, appropriate treatment, healthy lifestyle and follow-up.