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Diabetes and Coronary Heart Disease

Discussion in 'Diabetes Discussions' started by Dillinger, Sep 29, 2009.

  1. Dillinger

    Dillinger Type 1 · Well-Known Member

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    Hi,

    It seem uncontroversial to say that the risks of CHD for diabetics are fairly well established; here is a link that deals with just that http://journal.diabetes.org/diabetesspe ... 2/pg81.htm

    What I wonder is what is the explanation for that increased risk; does anyone have any information on the biology of increased risk of CHD as a consequence of having diabetes? Doesn't seem very clear to me?

    Not a particularly happy topic for a Tuesday afternoon, but there you go...

    All the best

    Dillinger
     
  2. IanD

    IanD Type 2 · Well-Known Member

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    I understand also that the presence of excess glucose in the blood has a particularly adverse effect on the capillaries that serve the nerve endings throughout the body, resulting in kidney disease, retinopathy, CHD, foot disease, etc.

    See:
    Long-term complications :
     
  3. Dillinger

    Dillinger Type 1 · Well-Known Member

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    Hi Ian,

    Thanks for that but I've got to say I'd bet quite a lot of money that the obesity and sedentary lifestyle bit is not going to go down very well here... :shock: :lol:

    It doesn't really provide an answer though either; it's essentially saying "if you've got diabetes your more likely to have CHD because you've got diabetes". Or it's putting diabetes into a set of causative risk factors rather than explaining what the link is.

    As I understand it a myocardial infarction is caused by the rupture of a atherosclerotic plaque in the wall of an artery and the clot which forms to deal with this then either blocks the artery or breaks off and moves 'downstream' and blocks off blood supply to heart muscle. So that isn't a capillary related problem; that's a full on artery getting into trouble.

    I wonder whether any studies say can say that this element of diabetes leads to this element of CHD and thereby increases the risk?

    All the best

    Dillinger
     
  4. catherinecherub

    catherinecherub · Guest

    Inflammation is the common cause that is cited now. Google, "inflammation causes heart disease diabetes".

    By googling," life expectancy and diabetes" you will come up with quite a few facts relating to heart disease.
     
  5. timo2

    timo2 · Well-Known Member

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    I'm thinking that thiamine deficiency sould be somewhere on our list of guilty parties.

    We also have to consider the vascular effects from an absence of (in type 1 and some type 2) or an excess of (in many type 2) c-peptide.
     
  6. Soundgen

    Soundgen · Well-Known Member

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  7. howie

    howie · Well-Known Member

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    hardening of arteries..? less elasticity and therefore more pressure on the heart, along with the reduction of the arteries size.

    i've also heard somewhere that reduced kidney function plays a role somehow.

    + a lot of T2's are overweight or have been for many years...
     
  8. NickW

    NickW · Well-Known Member

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    Hyperinsulinemia (chronically elevated insulin levels) is a commonly-cited causal factor in type 2 diabetes, and is also a percursor to hypertension, hypertriglyceridemia, obesity and an elevated risk profile for CHD. I think there's compelling evidence that it's not T2D itself that raises risk of CHD, but that both are effects from the underlying cause, which is hyperinsulinemia.

    Like everything else in biology, the correct answer is probably "it's complicated" and it's probably a combination of many different factors, but I believe that's a significant contributor.
     
  9. Soundgen

    Soundgen · Well-Known Member

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    this is from http://journals.cambridge.org/downl...62a.pdf&code=019c279598f868b6d69390f92ddf4fcd a study on rats where vitamin B6 lowers the rate of atherosclerosis by reducein elevated plasma homocysteine which is a risk factor for atherosclerotic disease. I wonder if diabetisc are prone to a B6 shortage as they are to B ? Other animal studies back this up thought another of which is http://sciencelinks.jp/j-east/article/200223/000020022302A0833308.php
     
  10. cugila

    cugila · Master

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    When I become a Diabetic Rat I'll let you know....... :D
     
  11. fergus

    fergus Type 1 · Well-Known Member

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    I think you're right NickW, that hyperinsulinemia is a significant factor and that other contributory hormonal responses add to the damage.
    There were 3 large scale prospective studies, I think in Australia, Paris and Helsinki, which reported a direct relationship between serum insulin levels and CHD risk. The higher the insulin, the greater the risk. This partly explains the link between obesity (again a result of hyperinsulinemia) and heart disease.
    The fact that insulin levels are a far better predictor of risk unfortunately isn't enough to direct the medical community's attention away from cholesterol, which is a very poor indicator of risk. This seems to be simply because insulin tests cost more than cholesterol tests!

    Plaques and damage to the endothilium are the visible evidence of an impending heart attack, so the question is which are the risk factors for 'endothilial dysfunction'? The accepted risks are high blood sugar, high insulin levels, high cortisol levels (often stress related) and high levels of adrenaline.

    So, I'm pretty certain that diabetes itself is not a direct cause of heart disease. However, poorly controlled blood sugar and insulin levels most certainly are.

    All the best,

    fergus
     
  12. Soundgen

    Soundgen · Well-Known Member

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    High blood plasma levels of Homocysteine are being connected to inflamation and heart attacks

    http://www.medicinenet.com/homocysteine/article.htm

    High levels of homocysteine are caused by lack of B vitamins

    http://en.wikipedia.org/wiki/Homocysteine

    Diabetics can have low blood plamsa levels of BI http://www2.warwick.ac.uk/fac/med/r...e/researchinterest/thiamine_and_benfotiamine/ Perhaps they also have depleted levels of the other B vitamins mentioned in Wikipedia ,
     
  13. howie

    howie · Well-Known Member

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    lol back to my kidney damage comment,

    cos kidneys involved in the re-uptake of B vitamins right?
     
  14. Soundgen

    Soundgen · Well-Known Member

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    I'm not sure about reuptake of B vitamins from the kidneys very interesting where did you see that ?

    This is interesting site fsponline-recommends.co.uk/page.aspx?u=Ubiquinol0409&tc=E975KA02&PromotionID=2147066075&u=10541129&g=0&o=92510&l=173597& although this is an advertising link for a product called ubiquinol a special type of coenzyme Q10 and may be removed by the moderators :( , I actually think it should be left as the information is interesting re heart attacks and statin use which depletes coenzymeQ10 from the body and as I understand NHS policy all diabetics are automatically prescribed 40mg of Simvastatin as soon as diagnosed ( Type 2 ) is it prescribed for type 1 as well ? If it is removed anyone who wants to read it will have to contact me by pm.
     
  15. Soundgen

    Soundgen · Well-Known Member

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    You and we are all already 25% rats :D as we share this amount of DNA with them , shared DNA is most likely to be about basic functions that's why you can look at rats and mice in diabetes and draw comparisons because the processes are the same


    http://www.sciencedaily.com/releases/2004/04/040401075930.htm
     
  16. cugila

    cugila · Master

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    Oh, right. :(

    So, I'm a quarter Rat, half lizard, and probably quarter Irish 'cause I drink Guinness ? :lol:
    I suppose you'll be telling me next I should be taking Vit B, or is that Benfloataminute ? (sp) ? :D

    Well I never.... :? :wink:
     
  17. Soundgen

    Soundgen · Well-Known Member

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    Cugila you've cracked it ! :D how many pints a day ?

    http://www.blackfive.net/main/2004/04/d ... ness_.html
     
  18. catherinecherub

    catherinecherub · Guest

    This one even wears a smart hat. :lol:
     

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  19. cugila

    cugila · Master

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    :lol: :lol: :lol: :lol: :lol:

    Have you seen this 'Tree Rat ?'.......... takes after me ?
     

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  20. Soundgen

    Soundgen · Well-Known Member

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