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Diabetes and Coronary Heart Disease

Dillinger

Well-Known Member
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
 
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 :
 
IanD said:
Compared with the nondiabetic population, the prevalence of dyslipidemia, hypertension, obesity, and sedentary lifestyle is higher in people with type 2 diabetes.
Click to expand...

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.

IanD said:
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.
Click to expand...

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
 
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.
 
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.
 
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...
 
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.
 
Atherosclerosis is the major cause of heart attack and stroke,
Click to expand...
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
 
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
 
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

Elevated homocysteine

Deficiencies of the vitamins folic acid (B9), pyridoxine (B6), or B12 (cyanocobalamin) can lead to high homocysteine levels.[4] S
Click to expand...
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 ,
 
lol back to my kidney damage comment,

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

Well I never.... :? :wink:
 
Cugila you've cracked it ! how many pints a day ?


http://www.blackfive.net/main/2004/04/d ... ness_.html
 
This one even wears a smart hat. :lol:
 

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

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