Diabetes harms the heart and vessels earlier than once thought
Diabetes and cardiovascular disease are closely related. But many of those who have diabetes are not even aware of the greatest risk entailed by the disease. They think the danger lies in metabolic dysfunction, when blood sugar levels rise too high or drop too low. However, there are in fact much greater risks associated with the harmful effects of diabetes on the heart and blood vessels.
In-depth research has considerably expanded our knowledge of cardio-diabetes in recent years. Scientists have discovered that even in the early phase of insulin resistance, there is a significantly increased risk of irreparable vessel damage. At that stage of the disease, most people do not even know they have it. They may assume that they are suffering “only” from impaired glucose tolerance. In this phase, the beta cells in the pancreas can still compensate for insulin resistance by stepping up insulin production. Already in this early stage of the disease, however, vessels can sustain severe damage. This is why many diabetes patients already display irreversible damage to the heart and vessels at the time of their initial diagnosis. For this reason, the usual check-ups are simply not enough. The early symptoms of diabetes type 1 and type 2 are very non-specific. The first signs may be a decline in performance, fatigue, severe thirst, increased urination, weight loss, greater susceptibility to infection, wounds that heal poorly, itching, or the typical acetone-like smell of the breath, similar to that of overripe fruit. Often, however, the disease initially shows no symptoms at all. This calls for expert knowledge and sensitive analysis on the part of medical specialists carrying out the diagnosis.
Today there are very reliable markers that can be used to pinpoint individual metabolic and cardiovascular risk very precisely at an early stage. They are called: intact proinsulin, C-reactive protein, and adinopectin. By monitoring these factors, the disease can already be diagnosed in its early stages. Clinical and empirical studies show, for example, that low values for the marker “adinopectin” are a sign of insulin resistance. The “intact proinsulin” level is likewise a highly specific marker for insulin resistance, but it also indicates whether the beta cells in the pancreas are functioning properly. If their function declines, they can no longer compensate for insulin resistance and the result is manifest diabetes. The third marker, so-called “C-reactive protein (hsCRP)”, provides clear evidence of chronic inflammatory processes in the vessel walls. These processes are responsible for a disruption in endothelial function (the elasticity of the arteries) and lead to deposits of LDL particles and the formation of plaques on the vessel walls. Actually, hsCRP is more than just a marker. It is an independent risk factor. The risk of cardiovascular disease increases almost linearly with the amount of hsCRP.
The good news is that the level of all three biomarkers can be positively influenced by lifestyle changes such as weight loss and exercise as well as by targeted medication. In the case of intact proinsulin and hsCRP, a therapy with combinations of different drugs has also shown good results. So it is definitely worthwhile diagnosing potential diabetes early on and beginning treatment if necessary. This is why the Cardiology and Diabetology departments at Preventicum work together closely.
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