Marilyn Lawrence-Wright | Diabetes and its affect on coronary heart well being | Commentary


This is one of Jamaica’s most distressing and widespread non-communicable diseases that affects heart health – diabetes mellitus.

Diabetes mellitus, or “sugar” as Jamaicans call it, is a condition that causes high blood sugar levels. It affects roughly one in eight adult Jamaicans and occurs when there is a problem with a hormone called insulin. This hormone is produced by the pancreas and carries glucose from the bloodstream to the body’s cells, where it can be used for energy. In type 1 diabetes, the pancreas does not produce insulin. This type of diabetes is more commonly diagnosed in children. In type 2 diabetes, the most common form of diabetes, the pancreas makes insulin, but the body is resistant to its effects. Insulin levels are high at first, but over time the pancreas burns out and insulin levels drop. Without enough insulin or its effects, glucose stays in the bloodstream and cannot get into your cells to give them energy to do their job properly.

Diabetes mellitus is diagnosed if you have a fasting blood sugar level of ≥ 7.0 mmol / L twice or an accidental blood sugar level of ≥ 11.1 mmol / L and have symptoms of diabetes such as frequent urination, excessive thirst, unexplained weight loss, or glycated hemoglobin A1 C ( HbA1C) (a measure of the average blood sugar level over the past three months) ≥ 6.5 percent or a sufficiently abnormal oral glucose tolerance test. Prediabetes, a precursor to diabetes, is also widespread in Jamaica. In this condition, blood sugar is higher than normal but not high enough to meet the criteria for diabetes mellitus. Prediabetes not only increases the risk of developing type 2 diabetes, it also increases the risk of stroke and heart disease.


Statistics from the American Diabetes Association and the British Heart Foundation confirm that people with diabetes mellitus are two times more likely to have a heart attack and 1.5 times more likely to have a stroke than people without diabetes.

Diabetes mellitus damages the human heart in a number of ways. Over time, high blood sugar levels can damage blood vessels and nerves throughout your body, including those that supply your heart. In addition to increasing blood sugar levels, diabetes triggers chronic inflammation (an activation of the immune system). Both conditions injure the walls of the arteries, making them more prone to developing atherosclerosis. This build-up of fats, cholesterol, and other substances on the blood vessel wall leads to the build-up of plaque, which can restrict blood flow. This plaque build-up in your coronary arteries (the arteries that supply oxygen-rich blood to your heart) leads to coronary artery disease and can cause a heart attack. Plaque build-up in the arteries that carry blood to your brain increases your risk of stroke.

Elevated blood sugar levels can also cause the arteries to stiffen, contributing to hypertension. They make platelets sticky and are more likely to form blood clots, which can starve the heart for nutrients and oxygen. Diabetes can also cause scar tissue to form in the heart muscle, which increases the risk of abnormal heart rhythms and heart failure when the heart loses its ability to pump blood properly. This can cause swelling in your legs and difficulty breathing due to fluid retention in the lungs. Diabetes can also damage the nerves in the heart, reducing the ability to detect insufficient blood flow to the heart muscle. People with diabetes mellitus are therefore at risk of a silent heart attack.

People with diabetes mellitus, especially people with type 2 diabetes, are more likely to have other conditions, such as high blood pressure, abnormal cholesterol, and being overweight or obese, which also increase the risk of heart disease. These associated conditions are often asymptomatic. Jamaicans are therefore encouraged to have regular tests to determine their health numbers. Do your blood pressure checks and a simple blood test to see if your sugar, cholesterol, or triglyceride levels are high. Diabetes is treatable. Even when glucose levels are controlled, many people with diabetes are at increased risk of heart disease and stroke. Therefore, the identification and aggressive treatment of all cardiovascular risk factors is critical.

Take care of your heart

Like most non-communicable diseases, diabetes mellitus continues to weigh on our health systems and can have devastating effects on households and families. According to the Jamaica Health and Lifestyle Survey 2016-17, the overall prevalence of diabetes mellitus among Jamaicans aged 15 and over was around 12 percent. This prevalence rose to 42 percent among Jamaicans aged 75 and over. The prevalence of diabetes and prediabetes was higher in women than in men. When addressing the COVID-19 pandemic, it should be noted that people with diabetes are up to three times more likely to suffer from a serious illness or die from COVID-19 than people without diabetes.

If you have type 1 or type 2 diabetes, you should take extra care to avoid the coronavirus that causes COVID-19 disease. Make sure you follow all recommended public health protocols for wearing masks, hand washing, and physical distancing. The good news is that despite the multitude of complications associated with diabetes and its effects on heart health, you can reduce your risk of heart disease or a heart attack.


Here are lifestyle changes that can help manage your diabetes and lower your risk of heart disease:

– Follow a healthy diet. Eat more fresh fruits and vegetables, lean proteins, and whole grains. Eat less processed, prepackaged foods (like french fries, candy, fast food) and avoid foods high in salt, sugar, and unhealthy fat like saturated fat and trans fats. Drink more water, less sugary drinks, and less alcohol. You can also consult a nutritionist to help plan meal times, which is important for people with diabetes.

– Aim for a healthy weight. If you are overweight, losing even a small amount of weight can lower your triglycerides and blood sugar. According to the CDC, modest weight loss means five to seven percent of body weight, only 10 to 14 pounds for a 200-pound person.

– Get regular heart disease checkups and manage your ABCs:

– Take a regular HbA1C test to measure your average blood sugar over the past 3 months. The aim is to stay in your target area as much as possible.

– Try to keep your blood pressure below 130/80 mm Hg (or the target set by your doctor).

– Manage your cholesterol level.

– Quit smoking or even better, don’t start.

-To become active. When you are physically active, your body is more sensitive to insulin, which helps you manage your diabetes better. Physical activity controls both blood sugar levels and your risk of heart disease. Try to do at least 150 minutes of moderately intense physical activity such as exercise for at least 150 minutes per week. B. to meet brisk walking.

– Coping with stress. Stress can increase your blood pressure and also lead to unhealthy behaviors, such as: B. drink too much alcohol or overeat. Try meditation or deep breathing, exercising, getting support from friends and family, or seeing a mental health counselor.

– Make regular visits to your doctor and take your medication as directed. Your doctor may prescribe medication to treat heart disease if you have diabetes. Some medications protect your heart by lowering high blood pressure, and you can benefit from them even if you don’t have a blood pressure problem.

– Be aware of your symptoms and report them to your doctor immediately. Symptoms of diabetes include increased thirst, frequent urination, blurred vision, slow-healing wounds, and fatigue. If you have been diagnosed with diabetes and experience symptoms of heart disease such as chest pain or pressure, shortness of breath, or tiredness, you should see your doctor immediately.

Call your doctor if you experience coronavirus-like symptoms, such as a dry cough, fever, or shortness of breath. Have your latest blood sugar levels ready to share with your doctor. As the COVID-19 pandemic continues to rage our country, taking care of your heart is more important now than ever, especially if you have diabetes. You and your health care providers can manage your risk factors and improve your heart health by changing your lifestyle and following the other aspects of your medical management.

Check your heart, be smart about COVID-19!

– Dr. Marilyn Lawrence-Wright is a consultant cardiologist with the Heart Foundation in Jamaica and the director of cardiology at the University Medical Center of the West Indies / University of the West Indies. Send feedback to