The link between diabetes and silent heart attacks

What do diabetes and a heart attack have to do with each other?

Not much, you’d probably say. They’re two seemingly unrelated conditions, right?

Not so fast.

The human body is more complex than that, and conditions that appear to be unrelated can have connections just below the surface that might surprise you… and that you should be aware of.

Medical experts have known a connection exists between type 2 diabetes and increased risk for heart disease, but protecting yourself isn’t so cut and dry.

That’s because having diabetes makes you especially vulnerable to the most dangerous heart attack of all — one you may not even be aware of until the damage is done.

The story of a ‘silent’ heart attack

A man in his 50s woke early one morning sweating and with a sharp pain in his left wrist. He went back to sleep, and upon reawakening the symptoms were gone and did not return. He went on with his day.

When the man went to his doctor to report the incident, an electrocardiogram revealed that the man had indeed suffered a heart attack and had a partial blockage of one of his coronary arteries.

Roughly half of “silent” heart attacks occur without causing any symptoms whatsoever.

The other half, as in this case, cause symptoms other than the typical pain in the chest and left arm. Instead, you might experience sweating, heartburn, fatigue or lightheadedness.

By some estimates, roughly 1 in 4 heart attacks is “silent.” This is likely an undercount because many of these heart attacks go unreported.

Why diabetics are more vulnerable

One of the common complications of Type 2 diabetes is nerve damage (neuropathy) caused by elevated blood sugar levels.

Some diabetics may be familiar with neuropathy causing a burning tingling sensation in their feet.

But autonomic neuropathy affects the nerves that control our internal organs, including the heart.

Someone with cardiac autonomic dysfunction (CAD) could be having a “silent” heart attack and not feel the typical sensations of chest pain or tightness, but be suffering heart damage nonetheless. And if you don’t know you’re having a heart attack, you may not get the medical help you need to limit the damage.

How to protect yourself

There are warning signs of CAD that involve other organs:

• Orthostatic hypotension (sudden lightheadedness upon standing)
• Gastroparesis (slow stomach emptying) where you feel full and bloated even hours after a meal
• Erectile dysfunction

If you have diabetes and suddenly start experiencing any of these, tell your doctor. It could save you from a heart attack.

Of course, managing diabetes well includes following the right diet. A meta-analysis of prospective cohort studies reviewed the differences among various diets’ effects in preventing type 2 diabetes. The authors concluded the DASH & Mediterranean diets were associated with strong potential and a 20 percent decrease in type 2 diabetes risk.

These diets are also high in antioxidant-rich foods known to improve glucose metabolism, decrease insulin resistance and improve vascular functions.

The Dash diet also lowers cholesterol and helps reduce weight — and lowers blood pressure, which is what it was developed for originally.

Those benefits fall in line with what the National Institute of Diabetes and Digestive and Kidney Diseases recommend for managing your ABCs, which can keep your blood vessels healthy and substantially lower your chances of having a heart attack…

A is for the A1C test. This test shows your average blood glucose level over the past three months. High levels of blood glucose can harm your heart and blood vessels.

B is for blood pressure. If your blood pressure gets too high, it makes your heart work too hard. High blood pressure can cause a heart attack or stroke and damage your kidneys and eyes.

C is for cholesterol. A buildup of cholesterol in your blood can cause a heart attack or stroke. Ask your doctor what your cholesterol numbers should be for your age group.

S is for stop smoking. Quitting smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels and cause circulation trouble, so your heart has to work harder. E-cigarettes aren’t a safe option either.

Sources:

What to Know About Diabetes and the Risk of Silent Heart Attacks — Time

People With Diabetes Are More Vulnerable to Heart Disease. How to Reduce the Risk — Time

Cardiovascular Autonomic Neuropathy: Overview and More — Very Well Health

Autonomic neuropathy — American Diabetes Association

Diabetes, Heart Disease, & Stroke — National Institute of Diabetes and Digestive and Kidney Diseases