A Short Note On Diabetes And Its Effects On The Risk Of Development Of Heart Failure Essay

Cardiovascular diseases has affected large number of population worldwide and in developed countries it is responsible for half of all deaths, coronary artery disease (CAD) alone is responsible for 1 of every 4.7 deaths in the United States (Eichner et al., 2002).

Systolic heart failure is characterized by enlarged ventricles that are unable to fully contract to pump enough blood into circulation to adequately perfuse tissues. The enlargement in ventricles is due to an increased end-systolic volume. If the heart is not able to sufficiently pump the expected volume of blood with each contraction, which in a normal healthy heart is 50-60%, there will be a residual volume left in the heart after every pump (Heart Healthy Women, 2012). With the next period of filling, the heart will receive the same amount of blood volume from the atria combined with that residual volume from the previous contraction. This causes the ventricles to have to dilate to accommodate this increase in volume. The dilation causes the walls of the ventricles to stretch and become thin and weak. Also the myocardium, the muscle layer of the heart, will stretch and not be able to adequately make a full and forceful enough contraction to push blood from the ventricles (Lehne, 2010).

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

1. List the risk factors for chronic left-sided heart failure related to coronary artery disease.

Diabetes mellitus (DM) is a pandemic that affects millions of people. The growth rate of unrecognized pre-diabetes in America is expected to rise up to 52% by 2020 (Lorenzo, 2013). As the prevalence of diabetes increases, so will the complications and burden of the disease. One of the leading causes for cardiovascular disease, renal failure, nontraumatic lower limb amputations, stroke, and new cases of blindness is DM (Lorenzo, 2013).

Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it

Risk factors play a role to cause congestive heart failure, but if having more than one of the risk factors, it increases one's risk. According to Daniel lee Kulick and Benjamin Wedro, Congestive heart failure is often a consequence of atherosclerotic heart disease and therefore the risk factors are the same. Poorly controlled high blood pressure, high cholesterol, diabetes, smoking, and family history are all contributors to being a risk factor of congestive heart failure. Heart valve disease becomes a risk factor of the patient throughout the years. Other causes of heart failure have their own set of risk factors and preferences and it becomes problem to those diseases.

Diabetes is a treatable and manageable disease however having diabetes increases one’s risk of developing heart disease. Diabetes mellitus increases the risk of cardiovascular disease by a factor of two to three at every level of systolic blood pressure (New England Journal of Medicine, 2010). Diabetes may be controllable with life style changes to keep insulin levels under control which can lower the chances of cardiovascular disease.

Individuals are more likely to develop CVD if they have high blood pressure, high cholesterol, are obese, use tobacco, eat a poor diet, or are not physically active. Most clinical risk factors that contribute to cardiovascular disease can be modified by practicing healthy lifestyle and behavior choices (Yu, Rimm, Lu, Rexrode, Albert, Qi, Willet, Hu, & Manson 2016).

When looking at age, recent studies in the US showed the prevalence of heart failure was increased form 0.7- 2.2% in people aged from 45-54 and a massive increase to 8.4% in persons above the age of 75 (Redfield,

Heart failure is mostly caused by other medical conditions that weaken the heart. These include coronary artery disease, hypertension,

Glucose fluctuations has been suggested as a main contributor to both micro and macrovascular complications, therefore tight glycaemic control was fought to benefit in patients with type diabetes mellitus. However, individual results from tree recent clinical trials—the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE trial), and the Veterans Affairs Diabetes Trial (VADT) failed to support a significant reduction in CVD events in the intensive glycaemic groups (Buse et al., 2007; Patel et al., 2008; Duckworth et al., 2009). In fact, in those studies intensive glucose control may increase risk in older patients with pre-existing CHD or longer duration of diabetes.

Diabetes mellitus (DM) is a condition in the body that is related to a faulty metabolism. It means that the body’s metabolism is not functioning properly, which leads to adverse effects in the health. The food we ingest, gets broken down into blood sugar (glucose), which is what fuels our body in the form of energy. This converted glucose needs to enter our cells so that it can be used for energy and growth. And in order for the glucose to enter our cells, there needs to be insulin present, which the beta cells of the pancreas is responsible for producing. This hormone is responsible for maintaining glucose level in the blood. It allows the body cells to use glucose as a main

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)