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What is Diabetic Cardiomyopathy?
Diabetic Cardiomyopathy (DCM) refers to changes in the heart muscle (myocardium) due to diabetes. It causes structural and functional changes in the myocardium. These changes are independent of other heart conditions such as hypertension and coronary heart disease. Pre-existing heart conditions could become severe due to diabetes.
Obese individuals with type 2 diabetes are found to be more prone to cardiomyopathy. Also, individuals with poor glycemic control are more at risk for developing cardiomyopathy.
An individual with Diabetic Cardiomyopathy could remain symptomless for a long time. The signs and symptoms of DCM may include weakness, shortness of breath, swelling of the hands and feet, fatigue, and severe cough.
For a diagnosis of Diabetic Cardiomyopathy, the healthcare provider will make an evaluation based on family history, physical examination, blood test(s), electrocardiogram, and stress tests.
Treatment options include proper glycemic control, managing the symptoms of cardiomyopathy (through medications), surgery, and bringing about certain lifestyle changes.
Cardiomyopathy could lead to heart failure and death. However, early diagnosis and adherence to a treatment plan could result in active and longer lives.
Who gets Diabetic Cardiomyopathy?
Diabetic Cardiomyopathy affects both men and women. Diabetic men are twice as likely to develop cardiomyopathy compared to non-diabetic men. Women with diabetes are 5 times more likely to develop DCM compared to women without diabetes.
Diabetic individuals of African-American and Hispanic origin are at a higher risk of developing cardiovascular risk factors in comparison to Caucasian or Chinese populations with diabetes.
What are the Risk Factors for Diabetic Cardiomyopathy?
Apart from being diabetic, an individual could have additional risk factors for Diabetic Cardiomyopathy such as:
- • Poor glycemic control
- • Prolonged high blood pressure
- • High blood cholesterol
- • A family history of cardiomyopathy
- • Obesity: Obese, diabetic individuals are more prone to developing DCM
- • Alcoholism
- • Smoking
- • Drug habit
- • Leading a sedentary lifestyle
- • Diabetic men are twice as likely to develop DCM and diabetic women 5 times more likely to develop the condition, when compared to non-diabetic age-matched individuals
- • African-American and Hispanic diabetic patients exhibit increased cardiovascular disease risk factors
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Diabetic Cardiomyopathy? (Etiology)
The chief cause of Diabetic Cardiomyopathy is being diabetic. Additionally, the following might exacerbate DCM:
- • Obesity
- • Chronic high blood sugar levels
- • High blood pressure
- • High blood cholesterol
- • Smoking
- • Drinking alcohol
What are the Signs and Symptoms of Diabetic Cardiomyopathy?
Diabetic Cardiomyopathy can be present in a diabetes affected individual without any symptoms for a long period of time. However, when symptoms do appear, they are likely to be:
- • Feeling out-of-breath after physical exertion
- • Swelling of hands, feet, ankles, and veins in the neck
- • Feeling tired or exhausted
How is Diabetic Cardiomyopathy Diagnosed?
To diagnose Diabetic Cardiomyopathy (DCM), a physician may employ one or more of the following methods:
- • A thorough physical examination
- • Learning about family history of diabetes and DCM
- • If asymptomatic, genetic testing to diagnose or rule out DCM
- • Blood tests
- • Urine analysis to test for presence of protein
- • Stress test
- • Chest X-ray
- • Tests to assess the heart function and condition that include:
- • Electrocardiogram (EKG)
- • Echocardiography
- • Biopsy of the cardiac muscle
- • Cardiac catheterization to check blood flow and pressure in the heart chamber
- • Coronary angiography in which a dye is introduced to check for blood flow in the heart chamber
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Diabetic Cardiomyopathy?
The following complications of Diabetic Cardiomyopathy are expected without proper treatment of the condition:
- • Diabetic-Induced Cardiomyopathy, when not diagnosed and treated early, could result in a poor quality of life
- • DCM, if left untreated, could lead to sudden cardiac arrest
How is Diabetic Cardiomyopathy Treated?
Diabetic Cardiomyopathy is treated by:
- • Reducing the factors that could contribute to the disease
- • Treating symptoms to improve the quality of life
- • Reduce the progression DCM
The above could be achieved by:
- • Controlling blood sugar within the healthy range, by adhering to the treatment regimen recommended by a physician
- • Maintaining a healthy body weight
- • Regular physical activity
- • Proper nutrition
- • Getting adequate rest and sufficient sleep
- • Reducing or managing stress
- • Smoking cessation
- • Reducing alcohol consumption
- • Kicking drug habits
- • Taking medication to lower blood pressure, if required
- • Taking medication to lower cholesterol, if required
- • If needed, taking blood thinning medications
- • If warranted, using medications to slow the heart rate
Surgery may be required in some cases to:
- • Implant devices to make the heart work better
- • For a heart transplantation
How can Diabetic Cardiomyopathy be Prevented?
Diabetic Cardiomyopathy is a heart condition that is associated with diabetes. It could be prevented by:
- • Controlling high blood sugar
- • Managing high blood pressure and high blood cholesterol
- • Maintaining a healthy body weight
- • Regular physical activity
- • Reducing stress
- • Getting sufficient sleep or rest
- • Limiting alcohol consumption
- • Smoking cessation
- • Avoiding illegal drug use
- • Adhering to physician recommended medication regimen
- • Having regular check-ups
What is the Prognosis of Diabetic Cardiomyopathy?
Currently, Diabetic Cardiomyopathy has no cure. However, early diagnosis and treatment, and regular check-ups, could lead to a healthier quality of life.