Cardio-metabolic illnesses: the slow killers (Part 2)

These potentially life-threatening conditions are referred to as slow killers because they produce no early symptoms that might alert you to danger. In today’s article, high blood lipids and diabetes are reviewed. 

Excess of fat in the blood, commonly known as hypercholesterolemia, is a disorder that afflicts up to 30 per cent of adults. Total cholesterol is deemed appropriate if below 200 milligrams per decilitre (mg/dL), borderline if between 200 and 239 and too high if it exceeds 240. Total cholesterol is assessed together with its two main fractions: LDL cholesterol, which is referred as bad cholesterol and HDL, known as good cholesterol.

LDL should optimally be below 130 mg/dL, but individuals who have other risk factors for cardiovascular disease may need to get lower than that to 100mg/dL. High LDL is considered the main lipid abnormality to watch and control. Conversely, low HDL-cholesterol (values below 40mg/dL) is also linked to an increased risk of heart disease. 

Ideally HDL levels should be above 60 mg/dL to confer cardio-protective effects and exercise is one of the best approaches to improving your HDL. Getting your lifestyle back in shape is essential because it will often bring lipids to acceptable levels without medications. Quit smoking, cut way back on the alcohol, reduce excessive body weight, eat more sensibly with the focus on low-cholesterol, lower intake of processed food, increase dietary fibre and more importantly, exercise regularly. The consumption of vegetables, fruits, pulses and whole-grain cereals, lean and oily fish (sardine, herring, salmon, trout) and poultry without skin is particularly encouraged. If total cholesterol or LDL levels remain too high despite real and prolonged lifestyle modification, your family doctor or a cardiologist is likely to prescribe an anti-cholesterol agent to achieve a satisfactory blood lipid control based on your cardio-metabolic risk profile.

Diabetes is one of the major public health challenges of the 21st century. The disease is associated with numerous complications that lead to significant morbidity and mortality. Type 2 diabetes – or maturity-onset diabetes that is responsible for the diabetes pandemic – occurs in adults and is linked to insufficient insulin production associated, most of the time, with poorly efficient insulin known as insulin resistance.

The concentration of sugar in the blood is called glycaemia or fasting blood glucose. Normal values are below 100 mg/dL and diabetes is confirmed when the glycaemia is above 126 mg/dL. Between these figures it is called pre-diabetes. 

In diabetes, the entry of glucose into the cells is impaired, which results in an excessive glucose concentration in the blood. Over the long term, the elevated glucose level becomes toxic to many cells and tissues – a process known as glucose toxicity. The resulting complications progressively affect many parts of the body, in particular the cardiovascular system, the nerves, the kidneys and eyes. It is thus of paramount importance to detect the disease at the prediabetes stage. At this initial phase, the minor impairment in glycaemia can be totally or partially reversed though lifestyle modification, namely getting back to a healthy body weight and engaging in serious physical activity. 

If your have prediabetes or diabetes, you need to be followed by a general practitioner and/or an endocrinologist as well as get additional assistance from a diabetes nurse educator. Diabetes is an illness that greatly benefits from efficient self-care. With proper awareness and compliance to treatment and lifestyle recommendations, most diabetics can enjoy a good quality of life over the long term.

 

DR GERARD LALANDE is Managing Director of CEO-Health, |which provides medical referrals for expatriates and customised |executive medical check-ups in Thailand. He can be contacted at [email protected]