The Silent Danger of Heart Disease in People with Diabetes

     Coronary artery disease (CAD), once regarded primarily as a health issue among the elderly, is increasingly affecting younger populations. Today, it ranks among the leading causes of death globally, including in Thailand. What many may not realize is that this disease has a significant connection with diabetes. It is one of the most common complications found in individuals with long-standing diabetes, particularly when blood sugar levels are poorly controlled.

This condition accelerates the deterioration of arteries throughout the body. Studies show that most deaths among diabetic patients are caused by coronary artery disease, with a mortality rate up to seven times higher than in non-diabetic individuals.

Increased Risk of Heart Disease in People with Diabetes

• Diabetic patients are at greater risk of developing coronary artery disease at a younger age, and often with more severe symptoms than the general population.
• They have a higher likelihood of complications and mortality in the event of an acute coronary syndrome.
• The risk of death from coronary artery disease is 2 to 4 times higher in diabetic patients compared to non-diabetics.
• Coronary artery disease is the leading cause of death among people with diabetes.
• Female diabetic patients have a higher mortality rate from heart disease compared to male patients.
• Additional risk factors such as hypertension and high cholesterol are frequently present, further increasing the incidence of heart disease.

Why Preventing Heart Disease in Diabetics Is Crucial?

     People with diabetes often experience vascular abnormalities earlier than those without the condition. Plaque buildup in the arteries can rupture, triggering the formation of blood clots that acutely block arteries—potentially leading to myocardial infarction (heart attack) and increased mortality. When this occurs in diabetic patients, treatment outcomes are often less favorable. Therefore, preventing complications is far more effective than treating the disease after it has developed.

Why Diabetic Patients Are More Susceptible to Heart Disease?

• Elevated blood sugar levels contribute to the deterioration of arterial walls throughout the body.
• Diabetes results in increased levels of certain substances in the bloodstream that accelerate arterial degeneration.
• Patients with type 2 diabetes often experience insulin resistance and typically present with other risk factors such as hyperlipidemia, hypertension, obesity, abnormal blood clotting, and elevated insulin levels. These factors lead to abnormal structure and function of blood vessels, inflammation of coronary arteries, and a greater risk of sudden arterial rupture and clot formation.

Symptoms of Coronary Artery Disease in Diabetics

Chest pain in diabetic patients with coronary artery disease is often mild or absent, as the condition is frequently accompanied by peripheral neuropathy, which affects pain perception and makes diagnosis more difficult. Other warning signs that may indicate heart disease include:

• Unusual or excessive fatigue
• Tightness or pressure in the center or left side of the chest or upper abdomen
• Discomfort similar to indigestion
• Pain radiating to the inner arm
• Dizziness or fainting
• Cold sweats
• Palpitations
• Nausea or loss of consciousness

These symptoms can occur at any time, such as after eating a large meal, upon waking, in cold weather, after exercise, or during straining (e.g., during bowel movements in constipated individuals). These signs warrant immediate medical attention.

How Diabetic Patients Can Prevent Coronary Artery Disease?

1. Coronary Artery Disease Prevention

     Diabetic individuals must strive to maintain blood glucose levels within the normal range and address co-existing conditions such as high blood pressure, high cholesterol, and obesity. For those already diagnosed with coronary artery disease, proper self-care, regular medication, and routine follow-ups are critical for long-term health.

2. The Advantages of Diabetic Prevention

     Proactive management of diabetes is essential to reduce the risk of complications, especially coronary artery disease, which remains a leading cause of death among diabetic patients.

Consultation Available

Consult a specialist in diabetes and endocrinology at the Diabetes Clinic, open daily from 08:00 to 20:00.

Effective diabetes management is crucial for minimizing complications—particularly coronary artery disease, a major cause of death among individuals living with diabetes.