Complications in diabetes The main cause of death was cardiovascular disease



Diabetes, hyperglycaemia / metabolic syndrome / thrombocyte dysfunction, etc., Risk of cardiovascular complications

Cardiovascular disease in diabetes occurs in younger years, but is often present without symptoms.

A low dose of aspirin proves the first linear effects of cardiovascular disease in diabetics

Every November 14 is "World Diabetes Day". This is the day established by the International Diabetes Association (IDF) and the World Health Organization (WHO) in order to raise awareness of diabetes.

Diabetes mellitus is a metabolic disorder characterized by hyperglycaemia in which insulin is not well-secreted or its normal function is not achieved and blood glucose levels increase.

According to the Korean Diabetes Association, one in seven (14.4%) of adults over 30 years of age is diabetes in 2016. In addition, the level of diabetes control revealed that only 6 out of 10 adults with diabetes knew about diabetes Patient's glycemic index, the goal of glycemic control, was regulated to less than 6.5% (control rate).3

The reason for managing diabetes is a complication. Complications, instead of diabetes, cause discomfort in daily life or lead to reduced life expectancy. Among the complications, cardiovascular disease is the leading cause of death in patients with diabetes. They are followed by infectious diseases, malignant tumors and congestive heart failure.

* Among the deaths of six main hospitals in Busan in 2000-2004, patients with type 2 diabetes over the age of 30 years

The risk factor for cardiovascular disease, which is the most dangerous complication, is 2-3 times higher in men with diabetes and 3-5 times higher in women than in people without diabetes.

Choi Dong-hoon, director of the Severance Cardiovascular Hospital, said: "Diabetic patients have a greater risk of developing cardiovascular disease6 "Cardiovascular disease in patients with diabetes is more common in younger patients than those without diabetes and is more common in patients with no symptoms. Because lesions are multiple and extensive, prevention and treatment of cardiovascular therapy in diabetics is of paramount importance."

Cardiovascular complications of diabetes, why?

There are various causes, but they are characterized by the following factors.

The first is hyperglycaemia. It is known that high blood sugar levels alone proliferate the blood vessels and stimulate atherosclerosis of the blood vessels themselves.

Second, hypertriglyceridemia and low levels of HDL cholesterol are increased in patients with diabetes than in patients without diabetes, which plays an important role in the development of early atherosclerosis.

Third, hypertension. Hypertension is often accompanied by diabetes, which is the risk of atherosclerosis.

Finally, patients with diabetes have fibrinolysis, a platelet function, and so on, causing a coagulation phenomenon in which the blood is well closed. This can affect the blood circulation and lead to cardiovascular complications.

Symptoms of diabetes related to cardiovascular complications7

Cardiovascular complications in diabetes may include neuropathic symptoms, macrovascular injury, and microvascular damage.

Symptoms associated with neuropathy

• Diabetic neuropathy : Manual, Arm, Feet, With your feet
Sometimes there is pain and helplessness.. You will experience about half of people with diabetes,
This eliminates the possibility of damage to the feet, especially.

Great damage to the vessel,
Chest pain, Breathing problems

• chest pain, Breathing problems : Myocardial infarction, Angina, Heart failure
I have to be suspicious..

• headache, Dizziness, Abnormal excuse, Balance disorder : Profession(Cerebral infarction)I doubt.

• back ache : Peripheral artery
We suspect disease..

Capillary
Microvascular injury

• reduced vision, Visual disturbances : It may be associated with retinopathy associated with diabetes.

• reduced volume of urine, Edema : It may be associated with a reduced renal function.

Three ways to prevent cardiovascular events – Check the risk, ask for advice, take aspirin with low doses,

[STEP1] Check Compliance Management Check (Check)

To prevent cardiovascular complications, an expert should be consulted and managed with a checklist that can check the risk of cardiovascular disease in association with a common diabetes mellitus.

Risk
Control List[i],[ii]


ü For men 56Three, For women 66Be older than.


ü Relatively early age(Men
55Under three, Women 65Three
Below)Cardiovascular disease(Angina, Myocardial infarction)There is a family that happened..


ü I'm smoking at the moment..


ü Dan 30Minut
Abnormal movement(Walking includes)Do not do it.


ü Obesity, which is now over-accumulated in the body(ITM(BMI) 30 Upstairs)
Country.


ü Total cholesterol(240 mg /Dl
Upstairs) Or low-density lipoprotein(LDL) Cholesterol(160 mg /㎗ or more)If the number is high, High density lipoprotein(HDL) Cholesterol(40 mg /㎗ or less) Low.


ü They have high blood pressure or diabetes.

[ii]Guidelines for the treatment of dyslipidemia, 2015.

In addition, it is necessary to change the lifestyle more healthy. Cigarettes should be cut off, alcohol must be reduced to one or two per day, the food must be slightly balanced, vegetables and fish should be consumed. You should also take more than 30 minutes a day to maintain proper weight and bandwidth and reduce stress.

[STEP2] Low-dose aspirin, the first line of treatment for cardiovascular diseases in diabetics,

Consult a risk assessment specialist for cardiovascular disease and consider using medicines such as a low dose of aspirin. A low dose of aspirin is used to prevent cardiovascular disease by inhibiting thrombogenesis, alleviating blood flow and demonstrating thrombogenic effects in patients with multiple cardiovascular risk factors. In a recent clinical trial of patients with diabetes without cardiovascular disease, the risk of severe vascular events was 12% lower than placebo, with a dose of aspirin of 100 mg per day over the course of 7.4 years. The study also found that a low dose of aspirin was effective in preventing primary cardiovascular events in patients with diabetes who were previously thought to have less responsive to aspirin.

[STEP3] Another appearance of cardiovascular preventive, even low-dose aspirin should retain the habit (Take)

If you are taking aspirin at low doses due to cardiovascular disease, it is important that you take it regularly. If you stop taking it for no reason, the risk of cardiovascular disease may increase. It is important that you regularly take medication according to a medical prescription, along with diet management.

Choi Dong-hoon, chairman of the department, said: "In today's cold weather, special attention should be paid to reduced blood sugar, elevated blood sugar due to reduced physical effort, overeating and overeating, diabetes can develop or worsen, blood vessels may be closed and the likelihood of cardiovascular disease can increase. " "In particular, both diseases must be managed so that there is no misunderstanding that would lead to cardiovascular disease by neglecting diabetes management."

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References

2 National Health Insurance Institute, a late disease that can conquer diabetes, 2013.

3 Korean Society for Diabetes, Diagnostic Sheet in Korea 2018, 2018.

4 Park, KS, changes in the 10 year trend of causes of death in patients with type 2 diabetes mellitus.

5 Korea Association for Diabetes, Clinical Guideline 2013 [제3부]Diabetes and complications, 2013.

6 Designated Clinical Research Center for Diabetes Type 2, Ministry of Health and Social Welfare, Guideline for the treatment of cardiovascular diseases in diabetes, 2007.

7 Ministry of Health and Welfare, Diabetes and Cardiovascular Diseases, Center for Cardiovascular Diseases, National Hospital Chungbuk, 2018.

8 JNC Report 7, 2003.

9 Guidelines for the treatment of dyslipidemia, 2015

10 Nine Life Regulations for Prevention and Control of Cardiovascular Diseases, Ministry of Health and Social Welfare, 2011.

11 Raju N, et al. Effect of aspirin on mortality in primary prevention of cardiovascular diseases. Am J Med. 2011; 124: 621-9.

12 Collaboration with antithrombotic trials (ATT). Aspirin in primary and secondary prevention of vascular disease: a common meta-analysis of data from individual participants from randomized trials. Lancet 2007; 373: 1849-60.

13 Aspirin Protect your home use guide, October 24, 17.

14 Effects of Aspirin for Primary Prevention in People with Diabetes Mellitus, New Engl J Med, 2018.

15, Park, Korea Compliance medicines and cost burden by medical panel, Korea Health and Social Research Institute, 2011.

16 Biondi-Zoccai et al., Eur Heart J 2006; 27: 2667-74.

17 Tetsuro, seasonal changes in severe hypoglycaemia in patients with type 1 diabetes mellitus, type 2 diabetes mellitus and non-diabetes mellitus, medicine. 2014; vol.

18 A.Analitis, effects of cold weather on mortality: results of 15 European cities within the PHEWE project, American Journal of Epidemiology, 2008, vol.


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