Diabetes complications The main cause of death was cardiovascular disease



Diabetes, hyperglycemia / metabolic syndrome / platelet dysfunction, etc., Risk of cardiovascular complications

Cardiovascular disease in diabetics occurs at a younger age, but is often present without symptoms.

Low doses of aspirin show first consequences of cardiovascular disease in diabetics

Every November 14 is "World Day of Diabetes". It is the day set by the International Federation of Diabetics (IDF) and the World Health Organization (WHO) to raise awareness of diabetes.

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia where insulin is not well secreted or is not normal, and blood glucose levels are increased.

According to the Korean Diabetes Association, one in seven (14.4%) adults over the age of 30 has diabetes in 2016. In addition, the diabetes control level has shown that only 6 out of 10 diabetic adults were aware of diabetes (awareness) of patients treated (treatment rate), only 1 in 4 had diabetes The patient's glycemic index, the glycemic control target, was regulated to less than 6.5% (control rate).3

The reason why diabetes is to be managed is a complication. Complications rather than diabetes alone cause discomfort in everyday life or cause a decrease in lifetime. Among the complications, cardiovascular disease is the main cause of death in diabetic patients. Followed by infectious diseases, malignant tumors and congestive heart failure.

The deaths of six major hospitals in Busan between 2000-2004 were type 2 diabetics over 30 years of age

The risk factor for cardiovascular disease, the most dangerous complication, is 2-3 times higher in men with diabetes and 3-5 times higher in women than in non-diabetic patients.

Choi Dong-hoon, director of Severance Cardiovascular Hospital, said: "Patients with diabetes have a higher risk of developing cardiovascular disease6 "Cardiovascular disease in diabetics is more common in younger patients than in non-diabetic patients and is more common in symptomatic patients." Because lesions are multiple and extensive, cardiovascular prevention and treatment is crucial for diabetics. "

Cardiovascular complications of diabetes, why?

There are various causes, but the following factors are typical.

First, it's hyperglycemia. It is known that the high blood sugar content itself is detrimental to blood flow and promotes atherosclerosis of the blood vessels themselves.

Secondly, hypertriglyceridemia and low HDL cholesterol are higher in diabetics than in non-diabetic patients, which plays an important role in the development of early atherosclerosis.

Third, hypertension. Hypertension is often accompanied by diabetes, which is a risk of atherosclerosis.

Finally, patients with diabetes have fibrinolysis, blood platelet function, and so on, leading to a coagulation effect in which blood is well caught. This can interfere with blood circulation and lead to cardiovascular complications.

Symptoms of cardiovascular complications associated with diabetes7

Cardiovascular complications of diabetes may include neuropathic symptoms, macrovascular injury and microvascular injury.

Symptoms related to neuropathy

• Diabetic neuropathy : Hand, Arm, Leg, With your legs
Sometimes there is pain and helplessness.. You will experience about half of people with diabetes,
This eliminates the possibility of leg damage.

Injury to the main vessel,
Pain in the chest, Difficulty breathing

• Pain in the chest, Difficulty breathing : Heart-attack, Angina, Heart Failure
I have to be suspicious..

• Headache, Dizziness, Abnormal pronunciation, Disturbance of balance : Stroke(Brain infarction).I have to doubt.

• Lower back pain : Peripheral artery
We must suspect the disease..

Capillary
Microvascular injury

• reduced vision, Visual disturbances : It may be associated with diabetic retinopathy.

• Reduced urine volume, Edema : It may be associated with impaired renal function.

Three Habits to Preventing Cardiovascular Complications – Risk Control, Ask for advice, Take a low dose of aspirin,

[STEP1] Risk management of complications (control)

In order to avoid cardiovascular complications, it is necessary to consult with an expert and follow through a checklist that can control the risk of cardiovascular disease associated with common diabetes.

Risk
Checklist[i],[ii]


at For men 56Three, For women 66Be older than.


at Relatively young age(Man
55Three, Women 65Three
Below).Cardiovascular disease(Angina, Heart-attack).There is a family that happened..


at I am currently smoking..


at Day 30Minute
Abnormal movement(Walks are included).Do not do it.


at Obesity, which is now over-accumulated in the body(BMI(BMI) 30 Up).
State.


at Total cholesterol(240 mg /Mr
Up). Or low density lipoprotein(LDL) Cholesterol(160 mg /㎗ or more).If the number is high, High density lipoprotein(HDL) Cholesterol(40 mg /㎗ or less). Low.


at You have high blood pressure or diabetes.

[ii]Guidelines for the treatment of dyslipidemia, 2015.

In addition, lifestyle changes should be healthier. Cigarettes must be cut off, alcohol should be reduced to one or two times a day, foods should be slightly balanced, vegetables and fish should be consumed. You should also exercise more than 30 minutes a day to maintain the correct weight and waist circumference and reduce stress.

[STEP2] Low-dose aspirin, the first line of treatment for cardiovascular disease in diabetics,

Consult a specialist to check for the risk of cardiovascular disease, and then consider taking medications such as low-dose aspirin. Low-dose aspirin is used to prevent cardiovascular disease by inhibiting thrombogenesis, facilitating blood flow and demonstrating thrombogenic effects in patients with multiple cardiovascular risk factors. In the recent clinical trial of diabetic patients without cardiovascular disease, the risk of serious stroke was 12% lower than placebo and the aspirin dose was 100 mg daily for 7.4 years. The study also found that low-dose aspirin was effective in preventing primary cardiovascular events in diabetic patients previously believed to have lower aspirin responses.

[STEP3] A second view of a cardiovascular preventative, stable low dose of aspirin should maintain the (Take)

If you are taking low-dose aspirin due to cardiovascular disease, it is important to take it regularly. If you stop taking the product for any reason, the risk of cardiovascular disease may increase. It is important to regularly take medication in accordance with medical prescription and diet management.

Choi Dong-hoon, chair of the department, said: "In today's cold weather, special attention should be paid to low blood sugar levels, increased blood sugar due to reduced exercise, overeating and overeating, diabetes may develop or worsen, blood vessels may fall the probability of cardiovascular disease may increase. "In particular, it is necessary to manage both diseases so as to avoid misunderstandings leading to cardiovascular disease by neglecting diabetes control."

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Links

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5 Korean Diabetes Association, Clinical Guidelines 2013 [제3부]Diabetes and complications, 2013.

6 Designated Clinical Center for Type 2 Diabetes Research, Ministry of Health and Welfare, Guidelines for the Treatment of Cardiovascular Complications of Diabetes, 2007.

7 Ministry of Health and Welfare, Diabetes and Cardiovascular Disease, Center for Cardiovascular Disease, Chungbuk National University Hospital, 2018.

8 JNC Report 7, 2003.

9 Guidelines for the treatment of dyslipidemia, 2015.

10 Nine Living Rules for Prevention and Treatment of Cardiovascular Diseases, Ministry of Health and Social Welfare, 2011.

11 Raju N, et al. The effect of aspirin on mortality in the primary prevention of cardiovascular diseases. Am J Med. 2011; 124: 621-9.

12 Collaboration of Antithrombotic Trialists (ATT). Aspirin in primary and secondary prevention of vascular diseases: common meta-analysis of individual participants from randomized trials. Lancet 2007; 373: 1849-60.

13 Aspirin Protect your home product manual, 24/10/17.

Effects of aspirin on primary prevention in people with diabetes mellitus, New Engl J Med, 2018.

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