Diabetes is sneaky. Most patients feel fine, even with their blood sugar 50-100 points too high.
But behind the scenes, much is happening. By the time a person is diagnosed with diabetes, the risk of having a heart attack has already soared as high as that of a person who has already suffered one. And sometimes a diabetic has already had a heart attack without even knowing.
How is this possible? Does not everyone with a heart attack clutch his chest in agony and fall to the ground? No! Especially in diabetics, heart attacks may be brushed off as something else: heartburn, indigestion, fatigue, hypoglycemia.
Diabetes damages blood vessels, particularly coronary arteries – the arteries that carry blood and oxygen to the heart muscle itself. Diabetes also damages nerves – including the nerves that alert a person to cardiac ischemia (lack of oxygen-carrying blood to the heart).
Do you remember what it feels like to run so hard that your leg muscles cramp and become weak? That's what happens to the heart when it can not get enough oxygen. But if you can not feel the damage occurring, how will you know?
Leprosy and diabetes have this in common : nerve damage may occur to the degree that a person is unaware they are hurting themselves. Both lepers and diabetics may lose toes or even due due to untreated injuries. I've had diabetics step on a tack and not even feel it.
The heart can be damaged on this basis as well. Classic symptoms of heart disease may be minimal or absent. As a diabetic, you may have no chest pain, no arm pain, no shortness of breath. Or you may experience something as mild as the heartburn you had after eating spaghetti last weekend. Possibly, you may have sweating and nausea that you attribute to a low blood sugar.
Knowing all this, what should you do?
Hopefully you have a doctor who you have partnered with in your care. If not, find one right away. If your doctor has not submitted an annual EKG, request one yourself. If you experience chest pain, heartburn, shortness of breath, nausea, sweating, fatigue, or other symptoms, see your doctor to make sure they are not coming from your heart.
Diabetes often coexists with other risk factors for heart disease. If you smoke, you assuredly are a heart attack waiting to happen. Make sure your blood pressure is under control. Know what your cholesterol level is and ask your doctor how to lower it. If you're overweight, aim to lose at least 5% of your body weight.
Being aware of the risk is the first step. Now do yourself a favor, and take good care of yourself.
Copyright 2010 Cynthia J. Koelker, MD