Don’t let the weight fall on your heart!

it suffers from a disease is critical for survival. One such disease is diabetes. Diabetes and heart disease often coexist, with diabetes increasing the likelihood of heart disease over time.¹

Common forms of diabetes related heart risks:
The commonest form of heart disease is coronary artery disease (CAD), which presents as heart attacks. Diabetes damages the blood vessels of the heart.² Almost 75% of patients with diabetes die due to cardiac disease. Every 1% increase in hemoglobin A1c (HbA1c) above 6.5, increases the risk of CAD by 11%.²


In people with diabetes, death due to heart disease increases by 40% for every 5-unit increase in BMI above 25.² Diabetes increases a person's risk of developing heart failure, a serious condition in which the heart is unable to pump enough blood¹. Hospitalisation for heart failure is twice as common in people who are diabetic than it is in non-diabetics.²

Atrial fibrillation is the third form of diabetes-related heart disease, characterised by irregular heartbeats. Patients with diabetes account for about 30% of the cases³ of atrial fibrillation.

Weight adding to diabetes-related complications:
The risk is further amplified when you have diabetes and obesity. Diabetes itself is directly linked to obesity, with approximately 80% of people with diabetes being overweight or obese.² Overweight is considered as a BMI greater than or equal to 25, and obesity is a BMI greater than or equal to 30.⁴

The adverse health effects of diabetes when combined with obesity are described as 'diabesity'.⁵ Diabesity leads to various structural changes in the heart that affect its function and cause different types of heart diseases.² Hence awareness and responsive action to minimise the risk is crucial.

Diabesity elevating heart risks:
Excess weight exacerbates the heart conditions associated with people with diabetes. Excess weight leads to fat deposition in the arteries of the heart, causing further damage.

Compared to people with normal weight, excess weight or obesity is associated with a nearly 60% higher risk of chronic heart disease.⁷ Similarly, heart failure is closely linked to excess weight, with it developing ten years earlier in individuals with excess weight than those with normal weight.⁶

An increase of BMI by one unit increases the risk of heart failure by 5% in men and 7% in women.⁶ Again, people with excess weight have a 1.52 times higher risk for the development of atrial fibrillation compared to the normal weight population.⁶ Increased mortality is more common in those who are overweight.⁶

Finding a better path:
Weight loss can reverse adverse changes that occur in the heart due to diabesity.⁵ Exercise has beneficial effects on the heart. Aerobic, resistance, or combined exercise training along with necessary dietary modifications significantly reduces HbA1c.

Even a small weight loss of less than 5% can improve blood sugar levels. However, in some people with diabetes, the benefits of lifestyle modifications might not be significant, in that situation it is best to consult your doctor for guidance in managing diabesity. If diabetes and excess weight are intruding on your life, it is important to be aware and concerned about your present and future and be responsive if you wish to live a healthy and long life.⁸


References:

1. CDC. Diabetes and your heart. Available from Link. Accessed on 26 Feb, 2024.
2. García-Vega D, et al. Int. J. Mol. Sci. 2022:23:7886.
3. PhD LGMP. Maedica (Bucur). 2022 Mar;17(1):143-152.
4. WHO. Obesity and Overweight. Available from Link. Accessed on 27 Feb, 2024.
5. Ng ACT, et al. Nature Reviews, Cardiology.10.1038/ s41569-020-00465-5.
6. Csige I, et al. Journal of Diabetes Research. 2018; Article ID 3407306.
7. Bhupathiraju SN, et al. Circ Res. 2016; 118(11): 1723–1735.
8. Standards of Care in Diabetes 2024. Diabetes Care 1 January 2024; 47

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