Diabetes and Heart - When the metabolism goes to the heart

More than half of all diabetics die from a heart attack: this alone shows just how important good heart function is in the course of diabetes. Often a heart damage due to diabetes is recognized late. Conversely, it can happen that a diabetes disease is not recognized until a patient visits his doctor because of heart problems.

What is diabetes in the body?

Almost everyone knows that diabetes means too high a blood sugar concentration. But what exactly happens in the body when the blood sugar concentration is permanently too high? The high sugar content damages the blood vessels and causes the blood to clot faster: The number of platelets (thrombocytes) increases and the mechanisms that dissolve the smallest blood clots and inhibit blood clotting are disturbed. One speaks of a disturbed fibrinolysis. In addition, the blood is more viscous and sticky than usual - the blood viscosity is increased.

It is easy to imagine that this thick, sticky blood easily attaches to small vessels and clogs them (risk of heart attack and stroke!). In addition, the composition of the blood changes - more fats are released from the body cells (increase in blood lipid concentration) and the concentration of electrolytes (sodium and potassium) shifts.

Even in the cells, the sugar content is too high: Many processes such as the production of proteins, activation of immune cells or the release of hormones are disturbed at the molecular level. All this makes diabetics more susceptible to infections.

Diabetic macroangiopathy

Diabetes leads to macroangiopathy, which means that all large or larger blood vessels are affected by the sugar content: arterial blockage and occlusion are the consequences. In diabetics, atherosclerosis occurs up to 10 years earlier than in non-diabetics. In the area of ​​the heart, the clogged arteries lead to heart pain (angina pectoris) and in the worst case to a heart attack.

Diabetics have a significantly worse prognosis for heart attacks, strokes and circulatory disorders of the extremities. This can be explained by the fact that the high blood sugar affects the repair processes of the body, so that diabetics recover from such an event significantly worse than non-diabetics. Often, a diabetic before a heart attack also lacks a warning in the form of a heartache or a so-called dumb infarction occurs - an infarct without pain.

Diabetic neuropathy

In diabetics, the sensation of pain is limited, because the high blood sugar content in addition to the vessels also harm the nerves - the diabetic neuropathy is the result. Often, frumpy sensations on the feet and legs occur: tingling sensation, feelings and an increasing numb feeling are the most common symptoms.

Unfortunately, not only the nerves on the extremities are damaged, but also the nerve fibers of the sympathetic and parasympathetic, which form the autonomic nervous system. They affect heart rate, blood pressure and blood volume pumped through the heart every minute.

Normally the heart can adapt to all sorts of situations: When we do sports, it beats faster and more blood is pumped through - when we sleep, the heart rate drops. But as soon as the autonomic nervous system fails, the heart can no longer adapt to the needs of everyday life.

Diabetes often leads to so-called autonomic neuropathy, which means that the heart beats relatively quickly even at rest (resting tachycardia) and that the heart rate no longer adapts to the required stress. Also, the blood pressure, which otherwise changes depending on the body position, no longer adapts to sitting, standing or lying down (orthostasis).

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