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Diabetes is also a matter of the heart

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BusinessWorld Insights discussed link between type 2 diabetes and CVDs

The latest figures from the International Diabetes Federation show that 463 million adults are currently living with diabetes. Here in the Philippines, particularly, one in every 17 adults is found to be living with diabetes, with type 2 diabetes (T2D) contributing the most of these cases.

T2D, the most common type of diabetes, concerns more than just the pancreas for the inability to produce enough insulin. This type is often linked to cardiovascular diseases like heart failure, heart attacks, and strokes—making the disease a matter of the heart as well.

In time with the World Heart Day last September 29, BusinessWorld Insights held an informative talk with experts in the medical and pharmaceutical fronts about how T2D can be addressed to prevent heart problems.

Dr. Gilbert C. Vilela, vice-president of the Philippine Heart Association, pointed out that the effect of diabetes on the heart is very broad, mainly because the disease causes blocked arteries and is “directly toxic” to one’s heart.

“The heart is part of a tube system. The very first thing diabetes ruins are these tubes, the blood vessels,” Dr. Vilela said, adding that the disease can first inflame these vessels around the body and then block them.

He stressed, however, that the most disabling and most deadly effect of diabetes on someone’s heart is heart failure, wherein the blood cannot supply enough blood to the body.

For such reasons, the cardiologist continued, everyone should be aware that diabetes is a risk equivalent. “This means, if you have diabetes, most probably you have heart failure,” he said.

Dr. Michael Villa, vice-president of the Philippine Society of Endocrinology, Diabetes and Metabolism, also finds that the factors that cause diabetes can also determine one’s heart health.

“If you have elevated blood sugar, you tend to have chronic complications as well, involving the big and small blood vessels,” he said.

According to Dr. Villa, the risk factors to the development of diabetes include a patient’s family history of diabetes, hypertension, heart problem, obesity, and high cholesterol, among others.

“If you have risk factors, signs, and symptoms of diabetes, get yourself tested with a fasting blood sugar or an oral glucose tolerant,” he advised.

Moreover, Dr. Vilela advised people with diabetes to directly ask their physicians about their risks of having complications such as heart attack and stroke.

The cardiologist added that a patient’s age, years of having diabetes, cholesterol level, creatinine level, kidney function, and lifestyles (e.g., smoking, exercise) will determine how high is his or her risk of suffering from the complications.

“You do not just go to your doctor and ask how high your blood sugar is. You ask how your entire blood sugar is affecting your whole body,” he added.

For Dr. Villa, there should be a team effort between patients and physicians when discussing about diabetes, with patients confidently consulting their doctors and doctors interrogating their patients on how well they are managing their blood sugar. “If this relationship is quite robust and successful, then they will be able to defeat diabetes,” he said.

Need for increased awareness

The forum also took a look into how research on diabetes has progressed. Dr. Villa noted that there is now a better understanding of the disease process, better medications, as well as new diagnostic technologies to fine-tune treatment plans in approaching elevated blood sugar.

Dr. Vilela, meanwhile, noticed that studies discovered that more than blood sugar, cholesterol should be targeted among diabetes patients, especially for managing heart complications.

On the other hand, Cihan Serdar Kizilcik, vice-president and general manager of Novo Nordisk Philippines, shared his realistic outlook on the development of management and cure of diabetes.

While medications have progress and new products have brought good cardiovascular outcomes, Mr. Kizilcik noted, there is still much to be done in increasing the awareness about this disease in order to decrease its prevalence.

“If you decrease the prevalence of diabetes by 1%, this prevents 111 million people from getting type 2 diabetes,” the general manager also shared.

He finds, however, that the number of people getting diabetes increases fast that it will be the “next biggest problem after the pandemic”.

Observing this, the pharmaceutical executive highly encourages widespread education on diabetes and how it can be prevented.

“The way to go forward…is to turn more into education and awareness and taking more responsibility by working with all the stakeholders,” Mr. Kizilcik said, “This is not just a [patient] and physician problem. This is a huge [societal] and educational problem as well.”

Furthermore, this education should start in children by teaching them the value of maintaining a stable bodyweight, exercise, and regular check-up, among other practices. In addition, family members with diabetes should be constantly encouraged to continue their treatment and follow up on their appointments.

For Dr. Vilela, the change in mindset should start with the mothers, since they are ones mostly in charge of the groceries and care in the family. “We should bring down the frontline to the families and tell them that diabetes is definitely a heart disease. It starts with increase in the blood sugar, but it would end up breaking your or your loved one’s heart,” he added.

He also suggested that the government should enable more spaces for activity, such as basketball courts and parks.

Dr. Villa, meanwhile, stressed the need to be properly informed about diabetes and its proper treatment. “We don’t want fake news. So, get the right information from the right sources,” he said, recommending getting facts from medical professionals and health organizations.

He also noted that there are lifestyle-related factors that can be changed in order to prevent diabetes. “You stop smoking, have a healthy diet, and exercise. It will go a long, long way in preventing disease or even helping…lower the burden of the disease.”

Dr. Vilela agrees with lifestyle change, stressing that having diabetes is really up to individuals. “It’s time to dictate our trajectory. Take your health in your hands,” he encouraged.

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