The urgency of addressing this issue is highlighted by forecasts of 330 million diabetes cases worldwide by 2050. This figure represents a staggering 3% of the predicted global population. The mechanisms that link the onset of diabetes with subsequent development of CVD include above-average lipid levels, inflammation of vascular walls, high blood pressure, and an excess of ‘bad’ cholesterol produced by the liver. Additionally, the effects of continuing to smoke are particularly potent for diabetics, with a dramatic increase in mortality rates being an inevitable outcome. Despite this, most diabetics can greatly alleviate the symptoms of CVD by making sensible diet and lifestyle choices.
Speaking for the ESC, Professor Joep Perk of the School of Health and Caring Sciences at Linneaus University in Sweden, and Board Member of the European Association of Cardiovascular Prevention and Rehabilitation (EACPR) says, “The impact of growing obesity levels is pushing Type 2 diabetes into an epidemic. It is a very serious problem for healthcare providers due to the cost of treatment, but also for cardiologists who now see diabetes prevention as one of the main health challenges. Around 60% of cardiovascular patients nowadays are pre-diabetic or diabetic, a significant increase from our experience of 20 years ago.”
Diabetics with CVD are urged to follow the ESC recommendations for patients which, quite simply, are summarised as:
• Eat a healthy diet
• Exercise more
• Stop smoking
• Limit alcohol intake
“Following this common sense advice will have a very positive impact on the progression of CVD. Although it would be good advice for non-diabetics, for diabetics it is literally a matter of life or death,” says Professor Perk. “The complications of CVD when added to the underlying effects of diabetes are a dangerous combination that should be avoided at all costs. This is why we stress the importance of diet and lifestyle changes to manage the progression of CVD.”
There are encouraging signs that prevention strategy in a wider sense is climbing higher up the healthcare agenda. The pioneering work of the Chronic Disease Alliance has recently been recognised by the prestigious European Health Award 2010. The Alliance was formed by the European Society of Cardiology and nine other not-for-profit healthcare organisations including the International Diabetes Federation. Its role is to give scientific guidance to the EU and other regulators in order to promote policies that will lead to long-term health improvements in the population. One example, for instance, is to limit the salt content in prepared foods. The objective of these policies is to encourage better diet and lifestyles which are key to the prevention of so many chronic diseases – a very timely message to mark World Diabetes Day 2010.