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Heart Surgery in Diabetics – Impact and Management

Diabetes and heart diseases have a strong connection. Statistics show that adults are more likely to develop heart diseases if they have diabetes; knowing that the American Heart Association considers diabetes as one of the major factors responsible for cardiovascular diseases.

The reason for this is that people with diabetes are very likely to have high blood pressure, and are more likely to be obese (because of slow metabolism). This may also mean a lack of physical activity for some individuals (which is one of the main reasons behind insulin resistance) and high cholesterol for others.

The sad truth of today is that both, serious heart diseases and diabetes are extremely common among Indians, which means that many heart patients across the country are also diabetic. This complicates the treatment of heart ailments, especially heart surgery, in such people.

The most common heart procedure most diabetics undergo is CABG (coronary artery bypass grafting). Research also states that diabetics face more problems post-heart-surgeries than non-diabetics.

Type of Diabetes More Prone to Heart Disease

There are multiple types of diabetes. Out of those, type 2 diabetes is more prone to heart diseases. Type 2 diabetes can lead to various diseases; from clogged arteries to heart failure. To prevent oneself from such disorders, one must learn about the heart diseases associated with diabetes.

Coronary Heart Disease: In this disease, the arteries of the patient, which carries blood from the heart, have a buildup of plaque. Plaque is a fatty, waxy substance that makes the arteries stiff. As more of it collects, the flow of blood becomes difficult and leads to clotting of the blood. This may increase the following diseases:

  • Arrhythmia: In this condition, the heart rates become unbalanced. The heart may skip a heartbeat, increase the beat rate, or flutter. This may cause a sudden cardiac arrest.
  • Angina: Angina is a condition in which one feels pain and discomfort in the chest. This may be felt in the arms, back or jaw. This could be the result of a particular activity or strong emotions.
  • Heart Attack: This is caused by clots that cut off the blood flow in the arteries. The symptoms of a heart attack include pain and discomfort in the chest area.

Heart Failure: In this condition, the heart doesn’t stop working. But, it becomes too weak to pump the required quantity of blood in the body. Diabetes and high blood pressure make one more likely to have heart failure.

The chances of these diseases increase if the patient is suffering from Type 2 diabetes.

Pre-Surgery Care for Diabetic Patient

Do you have Diabetes? Here are some tips to eliminate complications and risks during or after the surgery. You can put a cap on these risk factors by controlling your diabetes.

If the blood glucose level is not managed, it may develop the risk of infection. In emergency cases, there is no time to get your blood glucose under control. But, if your surgery is planned, you have time to manage your blood glucose by doing the following:

  • Before surgery, you should keep a check on your insulin level, to keep it under control.
  • Your cardiologist may recommend you to visit your diabetic specialist to help you get on track.
  • Do not miss your medication for diabetes.
  • Consume a healthy, well-balanced diet to control the insulin level. You should also exercise daily and try to reduce some weight.

No matter what, you should collect all the details about the procedure from your doctor. Any patient with diabetes needs special care before the surgical procedure. One must follow all the guidelines provided by the specialist to avoid any kind of complications.

Post-Surgery Care for Diabetic Patient

Keeping an eye on your blood sugar level after the surgery is extremely important. You should monitor it constantly to eliminate the long term complications. If your blood sugar is not controlled, the risk of your condition getting worse may increase. 

Work with your specialist to manage your blood sugar level. Take all the medications timely, provided to you by your surgeon. Ignorance may worsen your condition.

Dr.V Hariharan, a cardiologist from Indraprastha Apollo Hospital, talks about Heart Surgery in Diabetic Patients & explains how to maintain a Healthy Heart.

Complications

Some common complications associated with Heart surgeries of diabetic patients include:

  • Patients requiring Insulin are more likely to have a kidney failure
  • Diabetic patients need more medication before and post-surgery
  • Higher Chances of Heart Attacks and Strokes
  • Increased risk for Postoperative wounds, chest infection and urine infection
  • Tuberculosis risk in elderly patients
  • Improper Diabetes management due to surgery
  • Prolonged intensive care after surgery
  • Problems regarding the choice of anesthetic

But all of this doesn’t mean that if you require heart surgery, you choose to suffer in silence. One can take necessary precautions to ensure that the surgery is carried out with minimum risk. Reading up on recent researches and studies can also give a patient more insight into the steps one can take to ensure the most suitable treatment options.

According to the Harvard Heart Letter, Bypass surgery is a better option for diabetics than angioplasty. Another research conducted by St. Michael’s Hospital also suggests that diabetics have a 30 % lower mortality rate if they undergo coronary artery bypass surgery rather than angioplasty.

If one continues to eat healthily, maintain a proper lifestyle and find a good surgeon, the surgery and recovery can be taken care of smoothly.

Read on Recovery After CABG

This write-up was contributed to Credihealth by Dr. V Hariharan,  Consultant in the Department of Cardiology at Indraprastha Apollo Hospital in New Delhi.

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