Written by: Dr Beni Isman Bin Rusani, Consultant Cardiologist National Heart Institute (IJN) Kuala Lumpur

Human body has many major organs, and each has unique design to sustain life. For example, the heart is made up of muscle fibre to allow it to pump out adequate blood supply to various parts of our body. Whereas the kidneys have filtering mechanisms to remove toxin and waste without which could harm our body.

We often underestimate the deleterious effect of diabetes. In a healthy person, the body could regulate its blood sugar (glucose) level. However, this regulation renders ineffective in diabetes leading to elevated level of blood sugar. This in turn leads to various organs damage which include (but not limited to) heart, kidneys, and eyes. Heart disease and chronic kidney disease are two of the leading causes of death in Malaysia.

Diabetes is an established risk factor for heart disease. It does this by promoting inflammation and subsequent blockages of the blood vessels that supply oxygen to the heart (coronary arteries). At least 68% of people with diabetes over 65 years of age die of some form of heart disease. 

Furthermore, according to Malaysia 2019 Management of heart failure clinical practice guideline, heart failure and diabetes often co-exist in as many as 35-45% of cases; and men and women with diabetes have 2x and 4x respectively increased risk of developing heart failure as compared to those without diabetes.

Diabetes is also known to cause chronic kidney disease. It does this by promoting inflammation within the kidney cells and damages its function. Over time patients with chronic kidney disease could progress to kidney failure up to a point where the only proven therapy is dialysis. Diabetes remains the single leading cause for dialysis in Malaysia.

As the old saying goes, “Prevention is better than cure” –– this could not be overemphasized when it comes to managing chronic illness such as diabetes. The first step is by being aware that you are at risk of developing diabetes if you are:

The key is to prevent ourselves from developing diabetes in the first place. We can achieve this by practicing healthy lifestyles through eating healthy diet. Your diet should compose of vegetables and low unnecessary carbohydrates and saturated fat.

We also need to do regular exercise. Current recommendation by the American Heart Society is to do mild to moderate intensity exercise like brisk walking for about 150 minutes (about 2 and a half hours) in a week. These measures also help in reducing risk of developing other chronic diseases such as high blood pressure and high blood cholesterol.

Healthy lifestyle also proves to be beneficial for patients who already have been diagnosed to have diabetes. It helps patients to achieve good diabetic control. Doctors and other allied health specializing in managing diabetes such as diabetes nurse educators and nutritionist could assist patients and caregivers to develop a practical and well-rounded care plan that include healthy diet and lifestyle.

Patients and caregivers should have regular appointment with their primary care doctors, to ensure good diabetic control and detecting diabetes complications. If required, further consultation with medical specialties such as referral to cardiologist to manage heart disease, and to nephrologist to manage kidney failure.

There are many effective medications that are available to manage diabetes, heart disease and kidney disease. Research have shown that some types of medications have been proven to treat heart and kidney disease caused by diabetes.

Diabetes could lead to heart and kidney disease. Education and awareness are the keys in managing diabetes. Seek early medical help so that effective care plan and medications could be initiated to prevent further complications. This comprehensive approach requires not only doctors but also active participation from patient and caregivers.