Diabetes mellitus is a disease that occurs when the pancreas cannot produce enough insulin, or when it fails to act in the body because the cells do not respond to its stimulus. Those who suffer from this disorder are at greater risk of suffering from cardiovascular disease, and it is vital to learn how to prevent diabetes and keep this cardiovascular risk factor at bay. Dr. Prof. Francisco José Rodríguez Rodrigo, adult cardiologist, Expert in Cardiovascular Risk, Preventive Cardiology, Ischemic Heart Disease and Congenital Heart Disease.
Types of diabetes and their relationship with cardiovascular risk
Among the types of diabetes that can be suffered, the most common is Diabetes Mellitus, of which there are two types, according to the way in which they develop and when they occur.
Diabetes occurs when the production of insulin is insufficient, as well as if there is a resistance to its action. As glucose accumulates in the blood, called hyperglycemia, it progressively damages the blood vessels, both arteries and veins, and accelerates the process of arteriosclerosis, increasing the risk of cardiovascular disease: angina, acute myocardial infarction, as well as its complications and post-infarction mortality, and sudden cardiac death.
The cardiovascular risk of a diabetic person to suffer an event of these characteristics is equal to that of a non-diabetic person who has had a heart attack. It also increases the possibility of cerebrovascular disease or involvement of the peripheral arteries. Glucose does not need insulin to enter the brain, as it enters directly from the blood. It must be possible to maintain constant blood glucose levels between 60 and 110 mg/dl, which prevents damage to the nervous system.
Diabetes can damage different organs: the eyes, with progressive decrease of vision that can lead to blindness; the kidneys, with increasing loss of renal function, which can end in dialysis; the peripheral nervous system with alteration of the sensitivity of the lower limbs, which implies a serious risk of ulcers and amputations; the autonomic nervous system with digestive, urinary and sexual alterations, impotence, and the arteries of the lower limbs with risk of amputations.
Type 1 Diabetes Mellitus
Type 1 Diabetes Mellitus is frequently diagnosed before the age of 35 years, although it can also present at any age, and it is usually of search appearance. The cells of the pancreas responsible for insulin production are destroyed and stop generating insulin.
Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus is usually diagnosed in the period above the average age of life, above 40 years, although there are also infrequent cases in young people. This type of diabetes is essentially caused by a progressive resistance of the cells, especially of the liver and muscles, to the action of the insulin produced by the body.
There are also two other types of conjunctural diabetes:
- Gestational diabetes: diagnosed during pregnancy and may disappear after delivery.
- Induced diabetes: it usually appears as a result of drug interference, such as corticosteroids, or as a consequence of very rare genetic diseases, such as chronic pancreatitis, among others.
What are the causes of diabetes?
In order to better understand the concept of diabetes, we must first explain more extensively what glucose and insulin are.
Glucose: this is a form of sugar, which is the main source of energy for the human body and is obtained through food intake. When they reach the digestive tract, food basically contains carbohydrates, fats and proteins; it is these carbohydrates that give rise to glucose.
Insulin: a hormone that is responsible for collecting glucose and storing it in the liver, muscles and adipose tissue. To enter the cells, glucose needs insulin, which is produced in the pancreas when carbohydrate-containing foods are eaten. However, for insulin to be effective, two conditions must be met:
- That the pancreas produces insulin in sufficient quantity.
- That the cells are able to detect insulin and respond by allowing its action.
In addition to insulin, the pancreas produces another hormone called glucagon, which has the opposite effect. Glucagon is produced in fasting situations, and has the task of mobilizing the glucose reserves stored by insulin so that the cells can use them when needed.