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19 years
What is the connection between diabetes and mycardial infraction ?
Aug 20, 2014

Dr. Salim Saab Otolaryngology (ENT)
there is more myocardial infarction with diabetes than normal because of vascular lrsions as result of diabetes
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Dr. Zakia Dimassi Pediatrics
Individuals who have diabetes are at a 2-4 times higher risk of developing cardiovascular disease than people without diabetes. This is because conditions like hypertension, abnormal blood lipids and obesity, which are all risk factors in their own right for cardiovascular disease, occur more frequently in association with diabetes. Today, cardiovascular disease (including heart disease and stroke) is the number one cause of death in people with type 2 diabetes (non-insulin dependent diabetes, usually occurs more in adults but recently it’s becoming more and more prevalent in adolescents due to the obesity epidemic). In fact, at least 65 % of diabetic individuals die from some form of heart disease or stroke.
Diabetes is a chronic yet treatable disease, there is no cure, but you can control its progression. Yet even when glucose levels are maintained under control, diabetes still significantly increases the risk of heart disease and stroke. Here is how it happens:

Uncontrolled diabetes damages the blood vessels, rendering them more prone to the formation of atherosclerotic plaques (accumulation of cholesterol deposits that grow bigger and harder with time, may be complicated by formation of a blood clot, and gradually narrows the arteries and sometimes end up blocking arteries) and hypertension. People with diabetes develop atherosclerosis at a younger age and more severely than people without diabetes. Hypertension is more than two times more prevalent in people with diabetes as in people with normal blood glucose levels. Studies have shown a positive correlation between hypertension and insulin resistance (the tissues don’t respond properly to insulin, thus blood sugar remains high in the blood and does not get stored as glycogen).
People with diabetes are more likely to have a heart attack, than people who do not, and they fair worse.
In addition, diabetes can induce nerve damage, so a heart attack can be ‘silent’ because the typical chest pain is not felt.
The combination of diabetes and hypertension also predisposes to a higher risk of heart failure by two- to three-folds compared to people without diabetes. It also doubles the risk of a stroke as opposed to somebody with hypertension alone. The risk of transient ischemic attacks (attacks of interruption in the blood supply to the brain that are short-lasting and fall short from a full blown stroke) is between two and six times higher than somebody who does not have diabetes.
If you control your blood glucose you can reduce your risk of a cardiovascular disease event by 42% and the risk of heart attack, stroke, or death from cardiovascular disease by 57%.

Adequate blood sugar control reduces the risk of cardiovascular disease by 33% to 50%. Maintaining blood lipids at healthy levels reduce cardiovascular disease complications by 20% to 50%. Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts is often encountered in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes.
Weight loss and adopting a healthy diet will further improve the diabetes status. Weight loss can improve decrease insulin concentration and increase insulin sensitivity, thereby fighting against insulin resistance. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.
Physical inactivity (or as we call it, a sedentary lifestyle: having a desk job, sitting for long hours, using the elevator all the time instead of the stairs, using the car for transportation ) is another modifiable major risk factor for insulin resistance and cardiovascular disease. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke. It's likely that any type of moderate and/or vigorous intensity, aerobic physical activity—whether sports, household work, gardening or work-related physical activity—is similarly beneficial. You can start by using the stairs instead of the elevator, or parking your car at a distance from your work in order to walk a bit.
Smoking puts individuals, whether or not they have diabetes, at higher risk for heart disease and stroke.
If you have impaired glucose tolerance and lose weight, you can prevent the onset of diabetes.

The risk factors for Type 1 diabetes are still unclear. It is hypothesized that environmental triggers like viruses, toxins in the food chain and dietary components, may be involved.

The most significant modifiable risk factor for Type 2 diabetes is being overweight or obese. Smoking doubles the risk of cardiovascular disease if you have diabetes.

The most important non-modifiable risk factor is ethnicity, with Hispanics, Asians, Arabs, Africans, Pacific Islanders and indigenous (American, Canadian and Australian) populations at particular risk. Increasing age and a family history of diabetes also places you at greater risk.
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