Cardiovascular disease leading to heart attacks or strokes is by far the leading cause of death in both men and women with diabetes. Roche Dia:logue magazine speaks with Dr. Abdul Shakoor, a leading diabetologist with 25 years of experience, who examines the critical role of cardiac biomarkers in the treatment of diabetic patients.

There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. In 2021, 33 million adults in Pakistan were living with diabetes – a 70% increase since 2019. An additional 11 million adults in Pakistan have impaired glucose tolerance, while approximately 8.9 million people with diabetes remain undiagnosed, as per the most recent edition of the IDF Diabetes Atlas. With 1 in 4 adults living with diabetes, Pakistan is now ranked third in the prevalence of diabetes, following China and India.

Patients with diabetes are 2 to 4 times more likely than others to develop cardiovascular disease. According to the Framingham study, “people with diabetes are at more risk of having heart disease than the people without it.” This study was the first to contribute to the transformative discoveries of heart problems with diabetes. The Framingham study shed light on new ways of preventing, preempting, and treating patients more effectively.

According to the IDF statistics shared by Dr. Abdul Shakoor, “approximately 6.7 million people aged between 20 and 79 years have died from diabetes in 2021. That is around 1 death every 5 seconds.”

“Diabetes and heart disease often go hand in hand which is why cardiovascular disease is often the most prevalent cause of morbidity and mortality in diabetic patients.”

Dr. Abdul Shakoor reports, “the relative risk of cardiovascular morbidity and mortality in adults with diabetes ranges from 1 to 3 in men and from 2 to 5 in women compared to those without diabetes.”

Cardiovascular diseases associated with diabetes include ischemic heart disease, heart failure, stroke, coronary artery disease and peripheral artery disease. These complications can result in death for at least 50% of the patients. In Pakistan, more than a quarter (26.9%) of adults living with diabetes remain undiagnosed and almost 90% of them come from the middle-income bracket. Undetected and untreated, diabetes puts these patients at serious and life-threatening risks, including heart attacks, strokes, kidney failure, blindness and lower-limb amputation.

Timely screening and monitoring can play a key role in the early detection of cardiovascular-related risk factors.

By controlling blood glucose, monitoring blood pressure, keeping cholesterol in check and opting for a healthy lifestyle, cardiovascular diseases can be prevented or delayed.

However, the reality of many situations is that early warning signs are often ignored and diagnostic solutions are required to inform appropriate intervention. The use of tests to assess risk, screen, diagnose, predict, and monitor cardiac disease have been essential tools in protecting patients, helping to reduce anxiety, avoid overcrowding of the emergency department, and help save lives.

“Early intervention is crucial in preventing complications and this is only possible through preventive screening. Advanced cardiac biomarkers present new opportunities to personalize treatment, reduce unnecessary costs, and protect people in their time of need.”