• the heart blood vessels
• the heart muscle metabolism
• the blood staunching in the heart blood vessels
• the nerve fibers of the heart
Blood Vessel Damage due to Diabetes
Damage to large and medium blood vessels (macroangiopathy) is caused by diabetes especially by elevated blood fats, particularly elevated LDL cholesterol. This strongly promotes the development of cell clots, so-called plaques, on the inner wall of the blood vessels. Plaques narrow the blood vessels which cause circulation problems and can lead to an acute heart attack.
Damage to small blood vessels (microangiopathy) affects the blood vessels in the wall of the heart and is correlated with the duration of diabetes. It is caused primarily by elevated blood sugar, but also by elevated blood insulin levels in patients with diabetes type II. Both lead to the decline in elasticity and filtration ability, as well as a swelling of the smallest blood vessels. The heart is not properly supplied with blood and oxygen, especially in the area of the inner wall of the heart. This can lead to a heart attack.
Elevated blood pressure, a significant factor for the development of arteriosclerosis in the blood vessels of the body and the coronary vessels, appears earlier and more frequently with diabetics than with non-diabetics. Elevated blood pressure damages the inner wall of the blood vessels. The reaction is an increase in thickness and simultaneous loss of elasticity of the vessels. Additionally, cell clots develop frequently on the inner walls of the damaged vessels. The result is a reduction of the blood vessels’ diameter that can cause circulation problems with an elevated risk of a heart attack.
Damage to the Heart Muscle Metabolism
Diabetics show an accumulation of certain blood fats, the so-called triglycerides, in the heart muscle. On the one hand, this is often caused by an existing surplus of triglycerides in the blood.
On the other hand, triglycerides are produced in the cell metabolism of the heart because of an altered energy cell metabolism that comes along with diabetes. So there is an accumulation in the heart muscle, even without elevated blood triglycerides. The result is a diminished supply of oxygen to the heart with a higher risk for acute heart attacks.
Disturbances in the Area of Blood Staunching
In the long run, elevated blood sugar produces substances in the innermost cell layers of the blood vessels that change the process of blood staunching. This leads to a higher risk of thrombosis – blood clots made up of blood staunching cells – and consequently leads to a heart attack. Certain blood staunching cells, the so-called thrombocytes, are activated and become more prone to merge and form clots. Furthermore, these clots are more likely to get stuck on the damaged and consequently non-elastic blood vessel walls and ultimately clog up the blood vessels.
Damage to the Nerve Fibers of the Heart
Diabetes damages nerve fibers responsible for the tension and relaxation of the heart and the sensation of pain. The outcome is a faster pulse during relaxation periods, disappearance of the normal differences in pulse and blood pressure (day and night), sudden drop of blood pressure when standing up and while standing, as well as an inadequate rise in blood pressure and pulse, essential during physical exercise.
The diminished or non-existent sensation of pain often leads to the so-called silent heart attack in diabetics. Pain, an important warning symptom in critical circulatory problems in the heart or during a heart attack, is not noticed.
Examination and Care
Early detection of a diabetic heart disease is very important. The cardiologist performs certain examinations of the blood pressure, pulse, ECG, heart structure, size and heart functions.
Using telemedicine and telemedicine services is highly recommended for people with heart disease and elevated risk of heart attacks because an acute heart attack in diabetics can occur without the main heart attack symptom, pain.
Especially diabetics with a history of heart attacks clearly benefit from telemedicine and telemedicine services, because the cardiologist recommends ECG examinations more frequently. This can be accomplished with the distributed ECG equipment within the framework of telemedicine. The ECG equipment is easy to use. Prompt analysis takes place within telemedicine services and help is provided immediately when necessary.