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The Long-term Picture

Diabetes is linked to the development of a number of serious complications. The risk of developing complications exists whether you have type 1 or type 2 diabetes. Heart disease, for example, strikes many people with diabetes - particularly when they do not manage their diabetes well. Fortunately, by managing your diabetes, you can lessen your risk of heart disease and all the other complications.


Achieving good blood sugar levels play a large part in preventing complications, but it's suspected that genetics may also have a say. However, good control will reduce your chances of developing complications - and this means that, to a large extent, you are in control of your future.


If you already have developed a diabetes-related complication, rest assured that with early diagnosis and modern treatment results will be very good.


What Is A Heart Attack?



A heart attack (also known as a Myocardial Infarction or MI ) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen, causing injury to the heart muscle. Injury to the heart muscle causes chest pain and pressure. If blood flow is not restored within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is "complete." The dead heart muscle is replaced by scar tissue in six to eight week.


What Is A Stroke ?



The same theory applies to the Brain attack or strocke. End Result of that will obviously be paralysis in different grades.Brain Death whether of small areas or of large areas, occurs much faster within few minutes, as compared to the Heart Muscle Death.


Your Genetics with your life style & lipid levels may act as fuel. Diabetes & High Blood Pressure act as fire on the fuel.


Your Arteries…


Diabetes can cause blood vessel problems such as atherosclerosis (the build-up of plaque deposits in the blood vessels). This build-up can be particularly serious when it affects the coronary arteries, which supply your heart with blood.Some blocks can occur in your leg arteries and your Brain Arteries. All these are known as macrovascular disease.


We don't know yet why people with diabetes are more likely to develop cardiovascular disease. But, research has found that high blood sugar levels do cause damage to the arteries.


-> Taking Care of Your Arteries
-> Maintain good blood sugar levels.
-> Don't smoke.
-> Eat a well-balanced, low-fat diet. Consult a dietitian.
-> Keep a healthy weight.
-> Exercise regularly.
-> Check your blood pressure regularly.


Also, have your doctor regularly check your cholesterol and blood fat (triglyceride) levels.


Heart Disease and Stroke


People with diabetes are at very high risk of heart disease, also known as cardiovascular disease (CVD) and stroke (cerebrovascular disease). In fact, up to 80% of people with diabetes will die as a result of a heart attack or stroke. In addition, people with diabetes may develop these types of problems at a younger age and die from these events at rates much higher than people without diabetes (3 times higher for men and 5 times higher for women).


Reducing risk



The good news is that people with diabetes can lower their risk of heart disease and stroke considerably by paying careful attention to all of their risk factors. Working with your healthcare team to achieve the following targets is the key to good diabetes management. Achieving and maintaining a healthy weight through regular physical activity and healthy eating are important, but most people with diabetes will also require a number of medications to reach these goals.


Blood glucose target:

A1C of at least under 6.5 % (A1C is a blood test that is an index of your average blood glucose level over the preceding 120 days)
Blood pressure target:
130/80 mm Hg or lower
LDL (“bad”) cholesterol target:
less than 70 -100 mg% or lower

Controlling high blood glucose: Most patients with type 2 diabetes will require at least 1 or 2 medications (pills and or/insulin) to achieve recommended blood glucose targets. Diabetes is a progressive disease, so frequently increased doses and additional medications will likely be needed over time.

Controlling high blood pressure: In addition to the general healthy lifestyle advice above, it may also help to limit intake of salt and alcohol. Many patients will be prescribed a drug called an ACE inhibitor, which not only lowers blood pressure, but also offers protection against CVD. Again, frequently 2 or 3 blood pressure-lowering drugs are required.

Lowering high cholesterol: Most people with diabetes will be prescribed a drug called a statin to lower LDL (“bad”) cholesterol. Other drugs may sometimes also be used to increase HDL (“good”) cholesterol and to lower other blood fats such as triglycerides.

Daily aspirin therapy is also often recommended for people with diabetes. Aspirin helps prevent blood clots from forming. Aspirin is available without a prescription, but is not safe for everyone. Talk to your doctor about whether aspirin is safe for you and the dose you should take. For people who can’t take aspirin or who find it upsets their stomach, or in other specific situations, a prescription blood thinner called clopidrogel will sometimes be used.

Quit smoking. Smoking is a deadly habit. One of the best things you can do for your heart, diabetes and overall health is to quit now. Anyone who has tried to quit knows that it can be very challenging, so ask for help. You will increase your chances of success if you have support from your healthcare team and family. If at first you don’t succeed, try and try again.

Blood glucose target:

At every diabetes-related visit, your doctor should take your blood pressure. You should have your A1C measured every 3 months to monitor your blood glucose control.
Your blood lipid (fat) levels should be measured at least every 1 to 3 years (and possibly more often if you are on medications).

Ask your doctor for all of your test results and work closely with him or her to achieve the targets shown above.Don’t be afraid to ask questions about your medications or your lifestyle changes. The more you know about your disease and its treatments, the more you can participate in your own care.