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Silent Heart Disease With Some Diabetics
By Ng Peng Hock
Diabetes mellitus is a condition in which the body produces too little or ineffectively uses insulin, resulting in high levels of glucose in the blood. Diabetes has long been associated with heart disease. It is known that persons with diabetes are more likely to develop coronary heart disease (CHD) because diabetes can cause irritation of the blood vessel walls, adversely affect cholesterol profile and raise blood pressure. The prevalence levels of developed countries like United States and Australia are 8.3 percent and 7.4 percent respectively, as at 2004.
A report released in 2004 in the medical journal, Diabetes Care, revealed that more than one-fifth of patients with type-2 diabetes have decreased blood flow to the heart. However, no symptoms to suggest there is a problem.
This serious condition, known as myocardial ischemia, occurs when the heart does not receive enough blood to meet the metabolic needs, usually due to plaque build-up in the coronary arteries. Experts depict this disease as "silent" when there are no symptoms being presented. No chest pain is experienced and in fact there are no symptoms at all before a heart attack.
Doctors usually have had difficulty to detect the early-stage heart disease in type-2 diabetes patients because there may be nerve damage throughout the body. Chest pain, which is the heart's most important signal, is dampened considerably since insufficient blood and oxygen are obtained.
The study was conducted by a group of researchers from the Yale University School of Medicines in New Haven, Connecticut. The patients for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study were recruited in such a way that there was not even the slightest suggestion of the presence of heart disease.
The researchers had found that even in these patients with no symptoms, 22 percent had myocardial ischemia. In the DIAD study, the researchers analyzed data from 522 patients with type 2 diabetes. Of the patients with silent myocardial ischemia, only 60 percent met American Diabetes Association (ADA) guidelines for heart disease screening.
As suspected by the researchers, the rate of silent ischemia is even higher in the real world. The study again shows that diabetes is a very serious risk factor for heart disease. According to the researchers, the ADA should review its guidelines for screening heart disease for type-2 diabetes because they obviously miss almost half the patients with silent disease.
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