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Feature: Diabetics more likely to get heart attacks

24-Jun-2010 (Thu) The Straits Times

By Geraldine Ling

People with diabetes are twice as likely to have heart disease than non-diabetics.

Some 8.2 per cent of the adult population in Singapore have diabetes, a disorder in which blood-sugar levels are abnormally high.

There are two types of diabetes: Type 1 and Type 2.

Type 1 diabetes is a condition where the body produces little or no insulin, a hormone that helps maintain blood-sugar levels.

In Type 2 diabetes, the body has become resistant to the effects of the insulin it produces.

Of the two, Type 2 diabetes is more prevalent.

More kids affected

About 90 per cent of people with diabetes around the world have Type 2 diabetes.

While Type 2 diabetes usually strikes in middle age, more young people here are being found to have Type 2 diabetes.

In Singapore, Type 2 diabetes made up less than 5 per cent of all childhood diabetes 15 years ago.

Today, it accounts for about one-third of all childhood diabetes here, said Associate Professor Lee Yung Seng, a senior consultant in the division of paediatric endocrinology & diabetes at the University Children's Medical Institute at National University Hospital.

Children as young as eight years old are affected. However, most cases occur when a child is 12 or older, he said.

Part of the reason for this jump in numbers among the young of today is diet.

Dr Loh Keh Chuan, a consultant endocrinologist at Mount Elizabeth Medical Centre, said that many young people snack frequently on fast food, increasing their risk of getting diabetes.

Explaining this link, Dr Peter Yan, a consultant cardiologist at Gleneagles Hospital, said most fast food, like burgers and fries, are high in fat and refined carbohydrates, which can raise blood-sugar levels and cause obesity.

Heart attack risk

People with diabetes thus have a higher-than-average risk of having a heart attack.

Over time, high blood-sugar levels can hasten the accumulation of fatty deposits (cholesterol) on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis), said the National Institute of Diabetes and Digestive and Kidney Diseases in the United States.

The most common type of heart disease in diabetics, said Dr Yan, is coronary artery disease.

Coronary artery disease is a designated term for the narrowing of heart arteries by cholesterol deposition and typically involves the major arteries of the heart.

Coronary artery disease is more severe in people with diabetes, said Dr Yan.

Explaining, he said it involves both the major arteries as well as smaller ones. When smaller arteries also get clogged, this is known as small vessel disease. Damage is more widespread, said Dr Yan.

Small vessel disease is harder to treat because they are usually less than 2mm in diameter and are typically not suitable for coronary stents, said Dr Yan. Stents are the minute scaffolding used to hold open the walls of a blocked artery.

Professor Lee Kok Onn, the head of the division of endocrinology at National University Hospital, said it is important for young people to cultivate a healthy lifestyle to ward off diabetes.

Besides the heart health risks associated with diabetes, young people may also face rising insurance costs. Life insurance may be more expensive and difficult to get, said Prof Lee.

He believes a healthy lifestyle is not difficult to adhere to, provided one stops smoking, exercises more and avoids being overweight.

For those who are already diabetic, good control over the disease is key. This means visiting a general practitioner or diabetes specialist for medical checkups and keeping blood-sugar levels under control.

Levels of LDL-cholesterol, or bad cholesterol, should also be kept low to reduce the risk of heart attacks, said Dr Yan.

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