Diabetes And Matters Of The Heart

By Dr Gita Makan

Whilst COVID 19 dominated headlines in 2021 another more insidious plague continued unabated. At that time, there were 24 million adults between the ages of 20 and 79, in Africa living with diabetes.

Worryingly that figure continues to rise. By 2030, an estimated 33 million people on the continent will be affected by this disease. In many ways, diabetes can be considered to be the dark horse of non-infectious diseases. It is not as widely discussed as HIV, cancer or malaria in the African context, however in 2021 it was responsible for 416,000 African deaths.1

Diabetes is not selective and the diagnosis has been attached to such famous names as Johnny Cash, Tom Hanks and Patti LaBelle. The famous singer, LaBelle jokingly referred to herself as a “divabetic”.

Diabetes can lead to severe morbidity from chronic kidney disease, nerve damage, and vision and hearing impairment. However a potentially deadly complication is cardiovascular disease. As we
commemorate World Diabetes Day on 14 November, it is fitting to remind those at risk that heart disease is prevalent among people with Type 2 diabetes.4

In 2019 alone, more than one million deaths were attributed to CVD in sub-Saharan Africa. In the broader context that constitutes 5.4% of all global CVD-related fatalities and 13% of all deaths in Africa.3

People with diabetes are twice as likely to have heart disease or a stroke than people without diabetes.15. 30% of Type 2 diabetes patients will develop heart failure in their lifetime.12

Prevention begins with assessing your risk

As diabetes grows its footprint across the continent, so to does the burden of heart failure. And people with heart failure in Type 2 Diabetes have an increased risk of death compared with Type 2 diabetes without heart failure.13

But while the statistics may seem alarming, prevention is possible. A simple assessment from a healthcare professional can help diabetic patients at risk of CVD take life-saving preventative measures – even if they are asymptomatic when they are assessed.8

Why testing matters – even if there aren’t any symptoms

If you are assessed as having a high risk for developing heart failure by a healthcare professional, there are effective and safe interventions that can be provided to prevent the development of cardiovascular disease.8

Early assessment – the ultimate line of defense

There is now a straightforward science to assessing your risk of cardiovascular disease. It all beginsbwith a simple, relatively non-invasive blood test. Having provided a sample to a clinician, your test
will present biomarkers that can diagnose your risk of cardiovascular diseases.8

Your healthcare provider will order an NT-proBNP test to assess your risk or deliver a diagnosis.14

A visit to your healthcare professional who helps you treat your diabetes can result in him /her recommending this test to assess your risk of developing heart failure. Your healthcare professional will test or refer you for testing based on their risk assessment. Once you know your risk, documented treatment options like ACE inhibitors and beta-blockers can reduce your risk of developing heart failure.8

Ultimately, if you or a family member has diabetes – with specific emphasis on Type 2 – getting an early assessment can drastically reduce your risk of heart failure or provide the data your healthcare professional needs to treat you.7

The value of diagnostics in practice

Before assessing your risk of diabetes-related cardiovascular conditions, a healthcare professional must test for diabetes and advise you on treatment options.

According to the International Diabetes Federation, around 13 million adults living with diabetes in Africa remain undiagnosed. That is an astonishing 54% of the total number of adults with diabetes on the continent.1

Diabetes is a multifaceted disease that is increasing its reach in Africa. Together with CVD and other complications associated with it, it is a significant contributor to Africa’s burden of non-communicable diseases.11

While diabetes may be a disease that is managed rather than cured, modern diagnostics and treatments can be the catalysts for better quality of life in the long term. As celebrity chef Alvin Leung suggests, “Diabetes is not curable. It’s sustainable”.

If you have diabetes, take a moment to consider your risks and get an early assessment for cardiovascular disease. And if you suspect that you have any symptoms associated with diabetes, consult a healthcare professional sooner rather than later. For a list of the symptoms related to
diabetes, visit:
https://www.rochediabetescaremea.com/en/diabetes-basics/world-diabetes-day-what-diabetes

References:
1. https://www.idf.org/our-network/regions-members/africa/diabetes-in-africa.html#:~:text=5
2%20million%20adults%20(20%2D79,and%20117%20million%20by%202045.
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464771/
3. https://world-heart-federation.org/where-we-work/africa/
4. https://www.cdc.gov/diabetes/managing/problems.html#:~:text=Common%20diabetes%
20health%20complications%20include,how%20to%20improve%20overall%20health.
5. Gaede et al. 2003. New England Journal of Medicine. 2003, January; 348:383-393. 2.
Laakso, M. 2001. Journal of International Medicine. 2001, March; 249(3): 225-235. T2DM,
Type 2 Diabetes mellitus; CVD, Cardiovascular disease
6. https://patents.google.com/patent/US7608418B2/en
7. https://academic.oup.com/eurheartj/article/30/1/66/2398330
1. Huelsmann M, et al. J Am Coll Cardiol 2013;62:1365–72.
2. https://medlineplus.gov/lab-tests/natriuretic-peptide-tests-bnp-nt-probnp/
3. https://pubmed.ncbi.nlm.nih.gov/31183383/
4. https://pubmed.ncbi.nlm.nih.gov/31183383/
5. Rosano, G.M. et al., Card Fail Rev. (2017); doi: 10.15420/cfr.2016:20:2.
1. Bertoni AG, et al. Diabetes Care 2004;27:699–703.
2. https://ml-eu.globenewswire.com/Resource/Download/1f4fa400-1186-4791-8da7-b1c24a9
59e9c

3. https://www.cdc.gov/diabetes/library/features/prevent-complications.html

  • Dr Gita Makan is an Endocrinologist and Specialist Physician, Life Wilgeheuwel Hospital

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