Diabetes leads to high blood sugar, which can cause damage to the heart, blood vessels, eyes, and kidneys. People with diabetes are twice as likely as people without diabetes to experience heart attacks or strokes, and two out of every three diabetic patients die from stroke or heart disease.
The increased levels of sugar in the bloodstream from the diabetes cause diabetic patients to have more bad LDL cholesterol than good HDL cholesterol. Over time, this excess LDL cholesterol in the bloodstream gets inside the blood vessels and sticks to the walls, disrupting blood flow. This clogging of arteries eventually disrupts the supply of blood to the heart, causing heart attacks and strokes. Clogging of the vessels leading to the legs may cause peripheral arterial disease (PAD).
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The general symptoms before a heart attack include chest pain or discomfort, pain or discomfort in one or both arms, back, jaw, neck, or stomach, shortness of breath, sweating, nausea, indigestion, light-headedness or sudden and extreme weakness. Men usually experience chest pain, and women primarily experience shortness of breath, nausea, or back and jaw pain instead of chest pain. The symptoms may come and go.
Diabetes heart attack signs and symptoms may be mild or even absent, since the heart rate of diabetic patients during the attack stays at the same level as during exercise, inactivity, stress, or sleep. Diabetes might also have damage to the nerves that usually cause the chest pain, blunting the sensation.
Possible symptoms of such a silent heart attack include mild discomfort such as a squeezing feeling in the chest, shortness of breath, sleep disturbance, abdominal pain, increased fatigue, and heartburn, but silent heart attacks commonly occur even without such symptoms. Such silent heart attacks often remain undiagnosed, until picked up by a routine medical exam.
Although silent heart attacks are more common in diabetic patients, some diabetic patients also experience some or all symptoms of regular heart attacks.
Diabetes itself is a risk factor for heart disease and stroke.
People most at risk of a diabetes heart attack include middle-aged people with type 2 diabetes, especially women. People who have already suffered one such heart attack are most at risk of suffering a second fatal heart attack.
The general risk factors of heart attacks include people with family history of heart disease, central obesity, abnormal cholesterol levels, high blood pressure, and smoking. Central obesity is defined as carrying extra weight around the waist, as opposed to the hips, with a waist measurement of more than 40 inches for men and more than 35 inches for women.Such risk factors may cause heart attacks even without diabetes. With diabetes, these risk factors become more significant.
People having encountered silent heart attacks remain at extreme risk of encountering a second such heart attack, which could be fatal.
Regular medical check-ups, usually once every two to three months to keep tabs on cholesterol levels, blood pressure, and protein levels in the urine, are the most reliable in picking up warning signs of heart attacks. High blood pressure, high cholesterol levels, and high protein content in urine are all good warning signs of impending heart attacks, as all of these conditions occur when the heart, deprived of blood, becomes too weak to function efficiently.
The best prevention for diabetic heart attacks is a combination of regular medical examination and minimizing the risk factors to the extent possible. Medication and dietary and lifestyle changes that help keep diabetes in check also lessen the risk of diabetes heart attacks.
- National Diabetes Information Clearinghouse. Diabetes, Heart Disease, and Stroke. https://diabetes.niddk.nih.gov/dm/pubs/stroke/#risk
- The Cleveland Clinic Heart and Vascular Institute. Heart Attack Symptoms. https://www.clevelandclinic.org/heartcenter/pub/guide/disease/cad/mi_symptoms.htm
- American Diabetes Association. Know the Warning Signs of a Heart Attack." https://www.diabetes.org/type-1-diabetes/well-being/warning-signs.jsp
- National Heart Lung and Blood Institute. What Are the Signs and Symptoms of Diabetic Heart Disease?. https://www.nhlbi.nih.gov/health/dci/Diseases/dhd/dhd_signsandsymptoms.html