Hypertension, stroke, myocardial infarction and vascular aneurysm are among the complications cited by experts
On National Diabetes Day, celebrated on Wednesday (June 26, 2024), cardiologist Flávio Cure, member of the Brazilian Society of Cardiology and the European Society of Cardiologydrew attention to cardiovascular complications that diabetes that is not controlled with medication, physical activity and a healthy diet can cause.
Among them, he mentioned hypertension, myocardial infarction, angina pectoris, stroke and vascular aneurysm.
diabetes mellitus It is a metabolic syndrome of multiple origins, resulting from a lack of insulin in the body or its inability to adequately exert its effects, causing permanently high blood sugar levels (hyperglycemia). Many people are unaware that they have diabetes because the symptoms of this disease often go unnoticed.
Therefore, Cure, also coordinator of the Hospital’s Study Center CopaStar from Rede D’Or, recommended that people have periodic check-ups with a general practitioner, who will triage the patient.
“Everyone should do it. A very common symptom of diabetes that sometimes goes unnoticed is that the person starts to feel more thirsty and urinate more. Most of the time, in its initial phase, type 2 diabetes is asymptomatic.”the cardiologist told Brazil Agency.
In addition to frequent thirst and the urge to urinate several times, diabetes symptoms include chronic tiredness and lack of energy for everyday activities, according to the SBC (Brazilian Society of Cardiology).
“In diabetic men and women, the incidence of acute myocardial infarction and stroke is similar, but represents double when compared to people without diabetes. In women, the condition tends to be more serious, with higher mortality”said Cure.
According to the IDF Diabetes Atlas (International Diabetes Federation, in Portuguese), Brazil is the 5th country in the world in terms of incidence of diabetes, with 16.8 million adult patients aged 20 to 79.
It is behind only China, India, the United States and Pakistan. The estimated incidence of the disease in 2030 reaches 21.5 million.
Data from the International Diabetes Federation shows that up to 80% of patients with type 2 diabetes die from causes related to heart problems. At a global level, the rates exceed deaths resulting from HIV, tuberculosis and breast cancer.
Flávio Cure stated that patients with diabetes can avoid the risk of heart attack by controlling risk factors, “trying to normalize glucose levels, controlling cholesterol levels, exercising”. He also advised people to eliminate the smoking habit.
In diabetic people, autonomic neuropathy, a dysfunction that affects the sympathetic and parasympathetic nervous systems, can cause syncope, that is, fainting. Another important problem is CVA (cerebrovascular accident) which, in diabetics, can be confused with hypoglycemia.
“The person becomes confused and unwell. But hypoglycemia responds quickly to sugar replacement and the person returns to normal.”said the expert.
Cure also warned of peripheral vascular insufficiency, when arteries that supply the lower limbs are obstructed, leading to gangrene and lower limb amputations.
“It causes vascular problems, the vessels become damaged, the blood doesn’t circulate, gangrene develops and you have to remove (the limb). But nowadays, if you take care of yourself, it doesn’t come to that.”
The cardiologist spoke about the importance of patients with diabetes controlling their weight, reducing carbohydrate intake, exercising as much as possible and seeing a doctor periodically.
Kidney health
The president of Sonerj (Rio de Janeiro Nephrology Society), Pedro Tulio Rocha, nephrologist at Hospital São Lucas Copacabana, stated that increased blood sugar levels affect the body in a systemic way, overloading, mainly, the kidneys.
So much so that it is one of the main causes of chronic kidney disease and, consequently, of kidney transplants. According to the last Brazilian Dialysis Census2023, published by Brazilian Society of Nephrology32% of dialysis patients have diabetes.
Doctor Pedro Tulio Rocha told Brazil Agency that diabetes affects the kidney through a number of factors.
“Excess glucose is filtered by the kidneys and is harmful to the cells of the renal tubules and glomerulus (the kidney’s main filtration unit). Diabetes increases the deposition of cholesterol in the vessel walls. This process is called atherosclerosis and the kidney, as it is a very vascularized organ, suffers from this..“
He mentioned that there are also effects of diabetes on other organs, such as the heart and liver, which can lead to harmful consequences for the kidneys.
In the long term, you can develop kidney disease from diabetes, leading to chronic kidney disease.
The president of Sonerj stated that diabetes, along with hypertension, are the main diseases that lead to the need for dialysis. He also mentioned that kidney damage can be observed in pre-diabetes, but progression to more advanced kidney disease occurs with the presence of already established diabetes.
Study
Study recently published in British Journal of Sports Medicine shows that people who exercise more, at moderate to vigorous intensity, are less likely to develop diabetes mellitus type 2, especially those with high genetic risk.
Member of SBEM (Brazilian Society of Endocrinology and Metabolism), Dr. Rosita Fontes stated that practicing physical activities prevents and controls sugar levels when the muscles are working, that is, using blood glucose to produce energy.
As a result, the insulin that the body manufactures acts better and blood glucose levels decrease.
The specialist said that physical exercise is always healthy, even for those who cannot practice it for longer periods and for those who do not use as much intensity during the activity, as there is the benefit of preventing diabetes.
She recommends that, to get out of a sedentary lifestyle, it is recommended to start with light and brief exercises, such as short walks, and gradually increase both the duration of the exercise and its intensity.
According to the endocrinologist, physical exercise is also essential for those who already have diabetes (type 2 or type 1), because it helps control the disease, enhancing drug treatment.
The doctor recommended that before starting physical exercise, it is important that the person consults the doctor, as he or she will be able to assess, depending on the patient’s physical condition, weight and existing illnesses, how they can benefit from the activities, in to what degree they can be practiced and for how long per day.
Rosita Fontes reported that type 2 diabetes is one in which the pancreas produces insulin, sometimes even in increased quantities, but it is not properly used by the body.
It is the most common type, accounting for 90% of cases, with a higher incidence in adults. Type 1 diabetes tends to occur in younger people; the body cannot produce the insulin necessary to function properly.
With information from Brazil Agency.
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