Diabetic Cardiomyopathy: How Blood Sugar can Affect Your Heart

Diabetic cardiomyopathy

Diabetic cardiomyopathy, also known as DCM, is a disorder of the heart muscle in people with diabetes. It can lead to inability of the heart to circulate blood through the body effectively, a state known as heart failure (in which the heart cannot pump blood efficiently enough to meet the body’s needs), with accumulation of fluid in the lungs or legs or all over body.


Most heart failure in people with diabetes results from coronary artery disease.


Damage to the structure and function of the heart caused by diabetes. It is extremely prevalent: In one study, 52% of people with Type 2 diabetes had some degree of diabetic cardiomyopathies.


To understand how diabetes affects the heart muscle, it is important to understand how the heart normally functions. The heart has four chambers: two on top called atria and two on the bottom called ventricles. During each heartbeat, the chambers contract in a synchronized fashion. First the atria contract to fill the ventricles with blood. Then the ventricles contract, sending blood into circulation, as the atria relax to fill with blood again.


For decades, doctors have noticed certain changes in the structure and function of the heart that take place in people with diabetes. One of the hallmarks of diabetic cardiomyopathy is left ventricle diastolic dysfunction, which is impairment in the way the left ventricle fills with blood between heartbeats, along with increased filling of the atria.


People with Type 2 diabetes are more prone to having left ventricular hypertrophy, in which the left ventricle is enlarged. Left ventricular hypertrophy may be due to insulin resistance syndrome and could contribute to left ventricular diastolic dysfunction.


Another change seen in people with diabetes is myocardial fibrosis, which is scarring of the thick middle layer of the heart wall (the myocardium). Researchers believe that myocardial fibrosis may be due to high blood glucose levels.


Since diabetic cardiomyopathy is now known to be prevalent even among people with Type 2 diabetes who have no symptoms of heart.


Diabetic cardiomyopathy can be diagnosed definitively using various echocardiography techniques, which use reverberating sound waves to produce a moving image of the heart muscle in action.


A number of therapies can be used to prevent diabetic cardiomyopathy from progressing to heart failure. Good blood glucose control is essential, especially with medicines that decrease insulin resistance. Different classes of blood-pressure-lowering drugs may be helpful which alter the heartbeat to lower blood pressure.


How cardiomyopathy develops

Diabetes can cause changes in the body and the heart over time.


Those who don’t manage their diabetes well may experience long periods of high blood sugar, which damages blood vessels and nerves. In addition, obesity — often a factor in type 2 diabetes — strains the heart. Researchers link both issues to three reactions that take a toll on your body:


1. Increased release of hormones such as leptin, the “obesity hormone”

2. Chronic inflammation

3. Oxidative stress, which can damage DNA

4. Over time, these responses by your body may cause heart problems, including cardiomyopathy.


Tips for prevention

Studies show that the damage diabetic cardiomyopathy inflicts relates directly to blood glucose levels. So it’s important to keep those levels under control. Here are key tips to help you:


1. Get 45 minutes of moderate physical activity at least five days a week.

2. Monitor your blood sugar levels more frequently.

3. Eat a healthy diet (and limit your carbohydrate intake).

4. Take all medications/insulin prescribed by your doctor and make sure you follow your doctor’s advice religiously.

5. Get regular checkups for all blood sugar tests every three to six months.


If you keep your A1C levels regularly below 7, you can dramatically reduce your chances of heart-related complications.


Signs to watch for

It’s important to watch for signs of cardiomyopathy so that you can seek treatment quickly. The condition can occur even when diabetes is well-controlled, so see your doctor if you notice:


1. Unusual breathlessness with minimal or no exertion

2. Swollen ankles, legs and feet

3. Fatigue

4. Cough not linked to cold or flu

5. Abdominal bloating

6. Chest pain

7. Irregular heartbeat.


Screening and treatment

Screening for cardiomyopathy usually involves an echocardiogram (heart ultrasound), which provides a detailed picture of the heart.


If you do have cardiomyopathy, talk with your doctor about treatment options. It’s important to follow his or her suggestions to reduce your chances of heart failure. Depending on the severity of your condition, your doctor may recommend:


1. Lifestyle changes (stop smoking, exercise regularly, and eat a healthy diet)

2. Appropriate Medications

3. Procedures such as cardiac catheterization (to look at the blood vessels of the heart)

4. Bypass surgery or a heart transplant (for severe cases)

5. The best advice is to follow the tips to avoid complications and watch for signs of trouble. Your doctor also can help you monitor your condition.


Featured image courtesy: Pixabay.


Disclaimer: The views expressed here are solely of the author. My India My Glory does not assume any responsibility for the validity or information shared in this article by the author.

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Dr. Das Partha Sakha

Dr. Das Partha Sakha is an MD in Internal medicine and a Cert. Diabetician.

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