Diabetes and cardiovascular diseases: It's time to act (September 29 is World Heart Day)

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According to International Diabetes Federation's ‘Diabetes and Cardiovascular Disease report, in 2015, approximately five million were estimated to have died from diabetes, the majority of these as a result of cardiovascular complications. The report adds that populous countries have the largest absolute number of people dying from CVD, and include China, India and the Russian Federation.

While India is ranked at Number 67 in terms of age-standardised CVD mortality rate (306 deaths per 100,000 people per year), it has the second-largest number of people dying from CVD (over two million deaths per year).

One of the significant outcomes of cardiovascular disease is poor circulation in the legs, resulting in heightened risk of foot ulcers and amputations leading to disability. When people with diabetes develop CVD, their probability of survival is lower than those CVD patients without diabetes.

Diabetes can lead to cardiovascular damage in multiple ways. When a person has uncontrolled diabetes, the blood sugar levels are usually higher. And too much sugar in the blood damages blood vessels.

Although diabetes is regarded as the strongest risk factor for CVD, it is not just high blood glucose levels, but a variety of mechanisms that lead to CVD. The blood vessels in people with diabetes are more susceptible to well-established risk factors such as smoking, high cholesterol, high blood pressure and obesity. More than 80 per cent of people with type 2 diabetes are overweight. About 70 per cent of people with diabetes have high blood pressure and 67 per cent of adults with type 2 diabetes have one or more lipid (cholesterol) abnormalities.

Traditionally, the treatment of diabetes has been focused solely on good control of blood sugar levels.

Evidence now suggests that to prevent diabetes-related complications, one needs to look beyond glucose control and focus on other conditions like reducing weight, controlling high blood pressure and abnormal lipid profile.

In short, a person with diabetes needs to take care of the A, B and C of diabetes:

A stands for HbA1C (the test gives average blood glucose for last three months). It should be ideally less than seven per cent and is recommended at least three times a year.

B stands for blood pressure. The goal of blood pressure control is to reduce it to