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Peripheral Vascular

Therapeutic Approaches for Peripheral Artery Disease: Understanding Their Necessity

Introduction

Experience of any sharp pain or numbness in your legs after an extended period of sitting, painful cramps or aching in your hips, thighs, or calf muscles common and frequent after any physical activity, or coldness in lower feet, are signs of blockages in the arteries of the lower extremities. The condition is known as peripheral artery disease. As per reports, it is common, with nearly 41 to 54 million[1] estimated cases in India and nearly 4.2.to 6.2 million[1] people are afflicted by critical limb ischemia. According to the American Heart Association statement, approx. two hundred million people suffer from arterial blockages of the extremities worldwide.

The alarming statistics and the rising cases of other complications associated with arterial blockages in diabetic patients and people with smoking and alcohol consumption and/or obesity raise more significant concern for its stringent preventive measures and prompt and effective address.

The blog discusses the condition of arterial blockages, its causes, symptoms, and the treatment options for its effective control and management.

Peripheral Artery Disease- Its Causes and Symptoms 

Peripheral Artery Disease (PAD) results from the narrowing of the arteries that carry blood from the heart to the peripheral arteries as well extremities, commonly the legs. The lack of oxygenated blood supply due to the narrowing of the arteries causes ischemic pain. The causes of arterial blockages are-

  • Atherosclerosis – Plaque (fatty deposits) buildup over time results in the narrowing of the arteries, interrupting the blood supply to the peripheral arteries.
  • Thrombosis– A clotting of the blood in the narrowed artery is one of the reasons for arterial blockages.
  • Embolism– A condition of blocked artery caused by a blood clot or an air bubble in which the smooth flow of blood to the artery is interrupted, leading to an insufficient supply of oxygen. This causes pain, cramps, and other related symptoms of PAD.

Symptoms of PAD

People with PAD may not experience any symptoms until they become severe, which could at times adversely affect the heart health of the patient, if left unaddressed. This is so because PAD shares many common risk factors like diabetes, high cholesterol, high blood pressure, obesity, and smoking with heart disease.

The main symptom of PAD is claudication, where the person experiences flared cramping and pain in the legs and thighs when walking and subsides when at rest. The other symptoms include coldness in feet, numbness, tingling, or slow healing or unhealing of wounds.

Treatment for PAD

Preventing diseases and related complications is the best way to live a healthy life and enrich your quality of life. People with PAD are at a high risk of cardiovascular diseases and chances of stroke, heart attack, and other heart-related issues. Treatment for PAD requires rigorous and stringent healthcare precautions and aggressive lifestyle modifications.

Self-care and medications

A healthy diet, regular exercise, quitting smoking, management and control of comorbidities through medications, effective stress management, regular checkups, and monitoring through routine tests go a long way in preventing PAD and other related complications.

Surgical and non-surgical approaches

After the color doppler test, ankle-brachial index and vascular ultrasound test, the healthcare provider decides whether the patient needs surgical intervention to treat PAD. The severity of the condition is the primary and deciding factor for surgical intervention with other anatomical and health conditions of the patient.

Vascular Surgery

Known as open surgery or bypass surgery, the surgeon creates a new path around the blocked artery, using the healthy blood vessels from the other part of the patient’s body. This is known as grafting. The blood flows through the new path, bypassing the blocked artery.

During this bypass surgery, the patient is put on general anesthesia to keep them comfortable. The surgeon makes incisions to access the arteries and veins. The surgeon may use healthy veins like the saphenous veins (superficial veins in the legs), cephalic veins (veins from the arm), femoral veins (from thighs in case of more extensive artery grafting) from the patient’s body or use a synthetic material for grafting when natural healthy veins cannot be used. The surgeon sews the bypass in place and closes the incisions.

Endovascular Interventions

Atherectomy- It is a minimally invasive procedure to remove plaque from blocked arteries. During the procedure, the healthcare provider uses a sharp blade or laser attached to the tip of the catheter to cut or scrape out the hard plaque. The atherectomy could be Excisional (the blade cuts the plaque in one direction), Orbital (the plaque gets removed with a spinning tool), Rotational (the blade cuts the plaque in a rotating movement), or Laser ablation (the plaque is removed using laser) atherectomy.

Angioplasty – To treat any blood vessel damage, the interventional healthcare professional accesses them through minimal invasiveness. In endovascular intervention, the healthcare professional usually makes a tiny incision in the groin to gain access to the damaged arteries. Using the X-ray real-time images, the catheter, with a balloon attached, is guided to the damaged artery. Once in place, the balloon is inflated, pushing the plaque to the sides of the arterial walls, and paving the way for the uninterrupted flow of the blood.

In the case of angioplasty, the healthcare professional implants a stent, clearing the passage for the blood to flow in the affected artery. A stent, a small mesh tube, keeps the artery open for blood flow. Once the stent is placed, the balloon is deflated, the catheter is removed, and the incision is closed.

Apart from treating peripheral arteries, these stents are widely used to treat various artery blockages, like the coronary, renal, and carotid arteries.

Angioplasty has been gaining acceptance as a standard of care for treating blocked arteries due to its minimal invasiveness, resulting in less pain and tissue scarring, faster healing and recovery, shorter hospital stays, and quicker return to normalcy.

Conclusion

There are many risk factors common between PAD and heart disease; hence, effective control and management of one help to prevent the incidence of the other. PAD with other conditions of diabetes, high blood pressure, high cholesterol, or obesity puts the patient at a higher risk of heart disease. Rigorous, consistent, and aggressive lifestyle changes are a must for its prevention. However, in severe cases, where self-care, medications, lifestyle changes, and other alternate treatment modalities do not offer the desired results, surgical and non-surgical treatment options should be resorted to for timely and effective treatment.

The choice of the medical treatment option depends on the healthcare professional’s decision, arrived at after considering the severity of the condition, the age, anatomy, and overall health of the patient. Surgical and non-surgical treatment help repair the damage to the artery by removing the blockages. However, one must own responsibility toward one’s health and adhere to the doctor-recommended diet plan, exercise regime, and recovery plans, and quit smoking and tobacco consumption post-treatment for healthy living.

References

https://journals.lww.com/cmii/fulltext/2020/18030/endovascular_therapy_in_vascular_surgery___how.2.aspx#:~:text=41%E2%80%9354%20million%2C%20with%20an%20estimated%204.2%E2%80%936.2%20million%20patients%20of%20critical%20limb%20ischemia
https://www.heart.org/en/news/2023/06/15/routine-tests-may-reduce-disparities-in-peripheral-artery-disease-and-amputation-risk
https://www.narayanahealth.org/blog/what-is-peripheral-arterial-disease-pad/#:~:text=According%20to%20an%20International%20organization,built%20up%20in%20the

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Bariatric

Follow-Up: An Important pillar in the Life of a Successful Bariatric Surgeon

Among the many nuances of Weight Management, Bariatric surgery stands out as a transformative intervention for individuals struggling with obesity. Bariatric surgery, which includes procedures like gastric bypass, sleeve gastrectomy, and gastric banding, is a tool that aids patients in achieving substantial weight loss and addressing obesity-related comorbidities such as diabetes, hypertension, and sleep apnoea.

While the surgical procedure itself marks a significant milestone in a patient’s journey toward better health, the importance of follow-up care cannot be underrated. Post-bariatric follow-up plays a pivotal role in ensuring the long-term success, safety, and well-being of patients.

However, the surgery is just the beginning of a comprehensive treatment plan. Follow-up care is essential for several reasons:

  1. Monitoring Weight Loss Progress: After bariatric surgery, patients typically experience rapid weight loss followed by a gradual stabilization of their weight. Regular follow-up appointments will identify any deviations from the expected trajectory of weight loss, and make necessary adjustments to the treatment plan. This helps patients to reach the expected weight loss goals.
  2. Management of Nutritional Needs: Following bariatric surgery food intake is decreased to an extent over the first few months. Patients need guidance on adopting healthy eating habits, ensuring high protein food in the diet, protein powder supplements, vitamin and mineral supplements, and maintaining adequate hydration post-surgery. This can be achieved only with regular follow-up visits, during which tell-tale signs of any deficiency can be picked up instantly and addressed immediately to avoid long-term problems.
  3. Detection and Prevention of Complications: While bariatric surgery is generally considered to be safe in experienced hands, complications can arise during the post-operative period or later in the patient’s journey. These may include surgical complications such as leaks or strictures, as well as long-term issues like nutritional deficiencies, gallstones, or psychological challenges. When a patient follows up regularly, an untoward event can be identified quickly, minimizing their impact on the patient’s health and quality of life, and speeding up the recovery.
  4.  Lifestyle Changes: Successful weight management involves more than just physical changes; it requires a shift in mindset and lifestyle habits. Follow-up appointments offer opportunities for patients to discuss challenges, receive behavioural counselling, and access support resources such as nutritionists, psychologists, or support groups. Ongoing guidance and encouragement empower patients to make sustainable lifestyle changes and navigate the ups and downs of their weight loss journey.
  5. Long-Term Weight Management: Weight regain or incomplete weight loss is the challenge that each Bariatric surgeon faces at some time or the other during his/her bariatric practice. It could range from patient becoming a little callous/casual during their weight loss journey, to the associated knee pain or Osteoarthritis associated with obesity that prevents daily physical activity demanded after Bariatric surgery. If there is a regular follow-up, things could be noticed in time and necessary measures taken, and the patients can be motivated ensuring good results after bariatric surgery.
  6. Building Trust and Commitment: By prioritizing regular follow-up appointments, patients commitment is developed to a healthy weight maintenance, along with robust doctor and patient trust to supporting patients throughout their weight loss journey, which can enhance patient satisfaction, trust, and adherence to treatment recommendations.
  7. Support Group Meetings: Support group meetings play a vital role in the holistic care and long-term success of bariatric patients. These gatherings provide a platform for individuals who have undergone weight loss surgery to connect, share experiences, seek advice, and receive emotional support from peers facing similar challenges. The importance of support group meetings in the bariatric community cannot be overstated, as they offer numerous benefits that contribute to the overall well-being and success of patients:

A] Emotional Support: Support group meetings create a safe and non-judgmental space where patients can express their feelings openly, knowing that they are among individuals who understand and empathize with their struggles. Sharing personal stories and challenges helps foster a sense of belonging and validation, reducing feelings of isolation and loneliness often experienced by bariatric patients.

B] Peer Learning and Exchange of Information: From dietary modifications and exercise routines to coping mechanisms for managing cravings and emotional eating, patients can learn from each other’s experiences and gain valuable insights into what works best for them. Peer-to-peer learning fosters empowerment and self-efficacy, empowering patients to take ownership of their health and make informed decisions about their care.

C] Accountability and Motivation: Attending support group meetings provides patients with a sense of accountability and motivation to stay committed to their weight loss goals and adhere to the recommended lifestyle changes. Knowing that they will be sharing their progress and challenges with their peers encourages patients to stay on track and remain focused on their journey toward improved health and well-being.

D] Education and Empowerment: Support group meetings offer educational opportunities for patients to learn from guest speakers, and fellow attendees about various aspects of bariatric surgery, meal planning, portion control, mindful eating, body image, stress management, and coping strategies for handling setbacks and plateaus. By equipping patients with knowledge and skills, support groups empower them to make informed choices, adopt healthier habits, and take proactive steps toward achieving long-term weight management success.

E] Social Connection and Community Building: Bariatric support groups foster social connection and community building among patients who share common experiences and goals. Building relationships with individuals who understand the challenges and triumphs of the weight loss journey creates a sense of friendship, and mutual support that extends beyond the confines of the support group meetings. Patients often form lasting bonds with their peers, providing ongoing encouragement, inspiration, and accountability throughout their weight loss and maintenance efforts.

F] Prevention of Weight regain and Psychological Support: Research suggests that participation in support group meetings is associated with better weight loss outcomes and a reduced risk of weight recidivism following bariatric surgery. In addition to providing practical and emotional support, support groups address the psychological and behavioural aspects of obesity and weight management, helping patients develop healthy coping mechanisms, build resilience, and cultivate a positive mindset conducive to long-term success.

To summarize, regular follow ups and support group meetings are vital in the life of both, the Bariatric surgeon as well as the patient undergoing the Bariatric surgery.

The blog has been authored by Dr. Tulip Chamany, Bariatric and Metabolic surgeon. The content is for informational purposes only and should not be taken as professional medical advice. 

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Bariatric

World Obesity Day: Let’s Work Together to Fight Against this Global Health Problem

World Obesity Day is a powerful reminder of one of the most pressing public health problems that the world is facing. As the prevalence of obesity continues to rise, reaching epidemic levels in many regions, the need for coordinated efforts and the urgency to address obesity through innovative approaches has never been more concerning than it is today. The annual obesity program is a medium to raise awareness, encourage public participation, and support efforts to fight obesity and associated problems.

In the 21st century, due to evolving sedentary lifestyles, unhealthy diet patterns, and other environmental influences, obesity has become a significant threat to human well-being.

Let us consider the challenges and opportunities provided by world organisations on this World Obesity Day and reiterate our dedication to improving health equity, creating healthy environments, and helping people gain and maintain a healthy weight.

Together, we can create a healthier and more resilient world for our future generations.

What is obesity, and how does it affect you?

Obesity is the condition of having too much fat in the body. Body mass index (BMI) is the simple calculation of an individual’s height and weight used to define obesity.

  • BMI > 25 is considered overweight
  • BMI > 30 is considered obese

Obesity is not just a cosmetic problem; it is a medical condition that increases the risk of many other health problems, which include cardiac diseases, type-2 diabetes, hypertension, high cholesterol, liver disorders, certain types of cancers, etc.

Obesity is caused by a variety of factors, including genetics, an unhealthy diet, less physical activity, and other environmental factors. Gaining weight is easy, but it is hard to lose weight, and the reasons why people find it hard to lose weight are many.

However, losing a small quantity of weight can improve many obesity-related health problems. Traditional weight loss options like following a diet plan, regular physical activity, and other lifestyle changes can help you lose weight. When nothing works, bariatric surgery is the surgical option for treating obesity.

How can we tackle obesity with lifestyle changes?

Making necessary lifestyle changes is a healthy way to lose weight. A healthy diet and regular exercise are the priority changes one needs to make, to achieve and maintain a healthy weight. Moreover, it also helps to manage or reverse some obesity-related health conditions like hypertension and type 2 diabetes.

Doctors say that making lifestyle changes is not always easy. They recommend a customized weight loss plan based on your current diet, activity level, medications, and overall health.

Some people may achieve good weight loss just with relentless lifestyle changes alone, while others may need medication or bariatric surgery to help them lose weight more effectively.

Below are the top changes to be made in your life to achieve maximum weight loss.

  • Healthy Eating Habits (a balanced diet)
  • Regular physical activity (exercise)
  • Stay Hydrated (drink plenty of water)
  • Get adequate sleep
  • Manage stress
  • Seek social support
  • Set goals and practice self-care

Be patient and persistent, because weight loss can’t be achieved overnight; it takes some time. Do your part by staying committed to your goals.

Various treatment options are available to treat Obesity

Several treatment options are available to help obese people lose and maintain weight. Diet and lifestyle changes come first during the weight loss journey, where medications and surgery are other options.

Obesity treatment is often based on multiple factors, and there is no single treatment that works. One should strictly change their lifestyle even after weight loss surgery to achieve sustainable weight loss. In any weight loss journey, consistent positive change is key to progress.

What are the various surgical aspects of treating obesity?

Any weight loss journey starts with the traditional non-surgical options, and when they are not able to provide the required weight loss, experts suggest undergoing bariatric surgery. The majority of surgeries typically entail the reduction of size of the stomach and modifying the anatomy of the digestive system. These surgeries aim to change the way we absorb nutrients from the food we consume, which eventually promotes weight loss and also improves many obesity-related health conditions.

Here are some of the most common bariatric surgeries performed for weight loss:

  • Sleeve gastrectomy or gastric sleeve
  • Adjustable gastric banding
  • Gastric bypass surgery
  • One anastomosis gastric bypass (OAGB)
  • Duodenal switch
  • Revisional bariatric surgery

Advancements in the medical industry have led to the discovery of endoscopic sleeve gastroplasty or intragastric balloons for weight loss. These minimally invasive procedures use endoscopic tools to reduce the volume of the stomach without any surgical incisions.

Every surgical procedure has its benefits, risks, and eligibility criteria. However. the choice of surgery depends on many factors, which include BMI, medical conditions associated with obesity, patient choices, and specific recommendations from surgeons.

How will life be after bariatric surgery?

Life after bariatric surgery certainly opens the door to a new path for many individuals, which is healthier, longer, and more fulfilling than ever before. Though the journey of weight loss has many challenges, the benefits can be truly life-changing and outweigh the challenges, which help patients lead more confident lives than ever.

By adopting special guidelines suggested by the surgeon and remaining committed to their goals, patients can look forward to a brighter and more promising future. Remember, the key to successful weight loss relies on determination, patience, and self-care. We appreciate your journey to become a better and happier version of yourself!

The blog has been authored by Dr Venu Gopal Pareek, Consultant Laparoscopic & Robotic Bariatric Surgeon. The content is for informational purposes only and should not be taken as professional medical advice. 

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Peripheral Vascular

Life After Peripheral Arterial Stent Placement

Introduction

Arterial blockages are a slow and gradual narrowing of the blood vessels that carry oxygenated blood throughout the body. These blood vessels could be coronary (supplying blood to the heart), carotid (supplying blood to the brain and the head), peripheral (supplying blood to the body other than heart and brain), or renal (supplying blood to the kidneys) arteries that get blocked due to the accumulation of plaque (fibrous and fatty deposit) over time. This condition of plaque buildup, known as atherosclerosis, is the underlying condition in most arterial blockages. Also known as stenosis, blocked arteries hamper the regular smooth flow of oxygenated blood in the body, causing angina, claudication, kidney failure, high blood pressure, stroke, and other complications depending on the arteries affected by atherosclerosis.

Peripheral arterial disease (PAD) is one of the most common diseases with approx. two hundred million adults reportedly suffer from it, and the incidence increases to nearly 20% in older adults above 70 years. The disease affects the arteries of the extremities, often resulting in restricted mobility of the legs and the arms. The management and treatment for PAD starts with lifestyle changes, cardiovascular risk management, medications, alternate treatment modalities, or surgical or endoscopic treatment.

Continue reading this blog to know what to expect after peripheral artery stent replacement.

Peripheral Arterial Disease (PAD)

Atherosclerosis is the most common cause of PAD; the other causes may also include injury, inflammation, or exposure of the blood vessels to radiation therapy. The arteries of the legs and arms experience poor blood supply, causing symptoms of claudication (pain in the legs while walking and relief when at rest), and in extreme and severe cases, lead to gangrene.

People with diabetes, family history of PAD, smoking habits, obesity, high blood pressure, and high cholesterol are highly prone to developing the symptoms of PAD.

Lifestyle changes through a healthy diet, regular exercise, quitting smoking, stress management, and staying active helps control diabetes, blood pressure, cholesterol, and obesity, the contributing risk factors to PAD.

The treatment therapies aim to reduce the risk of PAD and improve mobility through exercises and walking. Patients less responsive to other therapies and lifestyle changes may need endovascular intervention

The procedure with a minimally invasive approach opens the blocked arteries by pushing the plaque to the arterial walls and placing the stent in the treated arteries. The procedure allows the smooth supply of blood to the extremities. Stents have been used for treating arterial blockages with high success and acceptance rates. Stents do not cure atherosclerosis. They treat the condition and relieve the patient from pain, discomfort, immobility, and dependence. Post-procedural care and management of the disease is a must for healthy living. Endovascular treatment with stent placement relieves the patient from the pain, inflammation, and discomfort associated with blocked peripheral arteries.

Alternatively, patients suffering from PAD can undergo a surgical treatment where a vascular surgeon cuts open the affected area and performs the procedure to cure the patient.

Life after Stent Placement 

Stents are a boon for people who are misfit for surgery and/or non-responsive to other treatment options. The stent placement as a percutaneous procedure offers lesser pain, faster healing, fewer tissue scars, faster recovery, shorter hospital stay, and sooner resumption to routine.

The life of the patients undergoing stent placement for peripheral arterial blockages changes post-treatment. They experience significant relief from the symptoms of PAD. They can live a life of their choice once they have completely recovered. Life becomes relatively active and enriching, with people able to manage their daily chores comfortably and without stress and pain. They regain a sense of worthiness and purpose as they are less dependent on others for their daily needs.

However, the comfort and ease of living a life require post-operative care and management. One must pay attention to the fact that prevention is the only cure. The life of an individual after stent placement may seem like below.

  • Immediately upon discharge from the hospital, the patient requires proper rest and downtime with physical activities for complete healing.
  • Wound care (Diabetic patients) becomes a priority in order to prevent infection and other complications.
  • Healing and recovery are faster with stent placement; compared to surgery, hence one is expected to resume routine in a week or two.
  • One must adhere to positive lifestyle changes to prevent its relapse.
  • With improved blood flow in the extremities, the patient feels less pain and more comfort in walking and staying active.
  • The need for regular follow-up with the doctor and routine medications may arise is mandatory to keep a check on the condition.

Conclusion

PAD is a progressive condition, often a sign of poor cardiovascular health. The symptoms may or may not be noticeable earlier. For the treatment for PAD to be successful and effective, one has to take ownership for one’s health by being consistent in living a healthy life through positive lifestyle choices.

Life resumes normalcy faster after stent placement than open surgery. The relief from pain and discomfort makes life enjoyable and fulfilling. The benefits of stent placement for PAD are multiple, provided one takes precautions with wound care (diabetic patients), regular follow-up visits with doctors, a healthy diet, regular exercises, excessive physical stress to the legs and the arms, controlling risk factors, and a positive mindset.

References

Peripheral Arterial Disease – StatPearls – NCBI Bookshelf (nih.gov)

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Heart Attack

The Silent Threat- How Diabetes Elevates Cardiovascular Risks

Introduction

Often, many people ignore those symptoms of mild heartburn or minor yet unusual discomfort of chest or shoulder pain, considering it an age-related normality. Sometimes, some might not even feel any symptoms of nerve damage, called neuropathy. This condition is commonly the result of poorly managed and controlled diabetes. Diabetes is a silent threat to the overall health of the patient since it often comes with no warning signs, taking people by surprise with its damage and severe consequences.

According to a study by the Indian Council of Medical Research, nearly 10.1 crores people have diabetes, and approximately 15.3 % of the population of India is pre-diabetic. These disturbing statistics indicate the dire need for awareness about the disease among the masses, effective prevention measures and strategies by agencies like the World Health Organization, and immediate treatment interventions by medical professionals to curb the onslaught of this silent killer.

Diabetes elevates cardiovascular diseases, and diabetic patients have higher risks of heart attack, stroke, nerve damage, and kidney failure, to name a few. To find out how, continue reading this blog.

About Diabetes, its Causes and Types

As a chronic health condition that is not only common in older people but prevalent in children and young adults also, diabetes is emerging as a health crisis, requiring strict and aggressive control and management. A disease that does not affect only one or two body parts but gradually and slowly affects one’s overall health if poorly managed and controlled. What starts as a sugar buildup damages various body parts like heart, kidney, eyes, nerves and blood vessels.

Diabetes is a condition when the sugar levels in the blood increase beyond the medically acceptable threshold limits. The pancreas releases a hormone, insulin, that enables the cells to convert food into energy by absorbing the sugar produced by the food. Often, when the pancreas stops producing or produces insufficient insulin, or the cells cannot utilize the insulin properly, the sugar levels in the bloodstream rise, leading to diabetes.

Types of Diabetes

Diabetes could be genetic or acquired. The causes of diabetes depend on the type of diabetes. The various types of diabetes and their causes are –

  • Type 1 Diabetes (type 1D)– Type 1D is an autoimmune disease where the immune system, by mistake, attacks and destroys the body’s own cells that make insulin. It is also known as insulin-dependent disease. The body cannot produce insulin, and the glucose is unabsorbed, resulting in its buildup in the bloodstream. This type of diabetes is caused genetically and is more common in children and young adults. Daily Insulin injections become a must for a patient’s survival.
  • Type 2 Diabetes (type 2D)- Type 2D is an acquired disease caused by obesity, lifestyle, and other environmental factors. It is an insulin-resistant disease where the cells do not properly use the insulin the body produces. The disease is manageable through medications and a healthy lifestyle, including a controlled diet, exercise, and other alternate treatment modalities.
  • Prediabetes- A condition where the sugar levels are above the normal limits but not as high as to be considered as type 2D. However, pre-diabetic patients are susceptible and liable to develop diabetes sooner or later if not managed and controlled timely.
  • Maturity Onset Diabetes in Young Adults (MODY) – Mutation in a single gene, if inherited by the child, may cause the chances of him/her developing MODY. This disease can be caused irrespective of the person’s weight or lifestyle. Timely and proper diagnosis helps control and manage it effectively.
  • Gestational Diabetes- Pregnant women may experience a rise in sugar levels that may attain normalcy after pregnancy. Weight gain and hormonal changes are considered responsible for gestational diabetes.

How Does Diabetes Elevate CVDs?

As an independent risk factor for CVDs, diabetes contributes massively to the poor prognosis of CVDs in people diagnosed with it. Diabetic patients are highly prone to complications of coronary artery disease, heart failure, stroke, heart attack, and other vascular diseases.

  • Link Between Diabetes and CAD There is a strong link between diabetes and CAD. Studies show that diabetic patients are two to four times more likely to develop CAD than non-diabetic patients. In people with diabetes, it is observed that atherosclerosis and atherothrombosis commence early and develop faster, resulting in one of the major reasons for high morbidity and mortality. High triglycerides (body fat) and high LDL (bad) cholesterol cause the arteries to harden, leading to atherosclerosis. The chances of plaque ruptures cannot be ruled out, causing thrombosis and, if unattended, may prove fatal.
  • Link Between Diabetes and Heart Attack Diabetes is reported to be responsible for the severe damage to the nerves of the autonomic nervous system. Angina or chest pain is one of the first symptoms of a heart attack. Diabetic patients do not feel chest pain, and heart attack often turn out to be silent.
  • Link Between Diabetes and Heart Failure Heart failure is when the heart cannot pump enough oxygen-rich blood efficiently and adequately to meet the body’s blood requirement. It has been studied that diabetes and heart failure have many similar risk factors, and each is an independent risk factor for the other. Diabetes Mellitus has been shown to worsen heart failure due to a rise in serum glucose, glycated hemoglobin levels, and reduced glucose tolerance. Cardiomyopathy (left ventricular dysfunction) is reported to be associated with diabetes, even in the absence of any other valve disease, hypertension, or CAD in diabetic patients. Diabetic patients are at high risk of heart failure, even without any symptoms of heart failure or structural heart disease.
  • Gestational Diabetes (GD) and its Associated Risks Women with GD have been reported to have a nearly seven-fold increased risk of developing type 2d in the long run. Diabetes is detrimental to the cardiovascular health of women. The risk of cardiovascular diseases due to diabetes is higher in women than men. This may be attributed to excess weight gain during pregnancy, the more extended period spent in the metabolic prediabetes stage that is unfavorable or placental hormonal effects, or an increase in inflammatory cytokines release during pregnancy causing insulin resistance. Incidence of GD may also affect the health of the baby, who may be born overweight, with chances of obesity or type 2D in the future or breathing problems.

Conclusion

Diabetes is not only chronic but life-challenging, with its devastating effect on the cardiovascular health of the patient. As a silent killer, it stealthily and gradually affects multiple organs and body parts adversely. To prevent any further damage and its aggravating impact on the person’s overall health, one must exercise stringent diabetes control and management measures.

References

https://pib.gov.in/PressReleasePage.aspx?PRID=1944600#:~:text=As%20per%20Indian%20Council%20of,of%20diabetes%20is%2010.1%20crores.
https://www.webmd.com/diabetes/silent-heart-attacks-diabetes
https://www.who.int/news-room/fact-sheets/detail/diabetes#:~:text=Over%20time%2C%20diabetes%20can%20damage,blood%20vessels%20in%20the%20eyes.

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