KARACHI, Nov 12: Pakistan will observe World Diabetes Day on Nov 14, with the theme “Diabetes and Cardiovascular Disease: Time to Act” in the backdrop of the fact that cardiovascular disease (CVD) has emerged as the main cause of death in people with diabetes in the country as in many other states around the globe.

Experts in an interview, on Monday, mentioned that approximately 80 per cent of all people with diabetes die of cardiovascular disease and also that people with diabetes are two to four times more likely to develop cardiovascular disease than people without diabetes.

Elaborating the co-relation between the two ailments, they mentioned that the major clinical manifestations of CVD could be divided into three groups: those affecting the heart and coronary circulation, those affecting the brain and cerebral circulation and those affecting the lower limbs and feet.

Atherosclerosis, the clogging of arteries (which otherwise nourish the heart), is an underlying cause of heart disease and people with diabetes or with too much glucose in their blood, again a major threat to a healthy heart, have two to four times the risk of developing atherosclerosis than people without diabetes.

With reference to CVD manifestation affecting the brain and cerebral circulation, it was mentioned that any interruption in blood supply to the brain leads to stroke. The key risk factor for stroke was reminded to be high blood pressure (hypertension), adding “Strokes occur twice as often in people with diabetes and hypertension as in those with hypertension alone.”

Peripheral vascular disease, which refers to diseases of blood vessels, excluding the heart and brain, often results from narrowing of the vessels that carry blood to the leg and arm muscles.

The very condition causes gangrene (death of tissue due to loss of blood supply which can ultimately lead to amputation) and intermittent claudication (a pain usually in the calves when walking due to impaired blood supply to the calf muscles, often an outcome of atherosclerosis).

“People with diabetes are 15 to 40 times more likely to have lower-limb amputation compared to the general population,” a senior diabetologist said.

One expert, commenting on the scenario, mentioned that many cardiovascular complications could be prevented through systematically addressing the known cardiovascular factors, particularly modifiable risk factors such as high fats in the blood, high blood pressure, obesity and smoking.

“Diabetes itself and raised blood glucose act as risk factors,” he said, adding that all risk factors should be treated to gain the most benefit in terms of reducing cardiovascular disease.

Experts reminded that the costs of diabetes and its complications affects everyone everywhere and that with the number of people with diabetes rapidly increasing, these costs are continuing to grow, heavily burdening the pockets of individuals and families, the healthcare sector, governments and society as a whole.

The financial costs of Type 2 diabetes include not only the direct cost of treating the disease, but also the cost of managing and preventing long-term complications. According to WHO sources, the average per-capita expenditure in European countries (for people with Type 2 diabetes) amounts to approximately US $2,500 per year.—APP